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AN ENGLISH TRANSLATION 

OF 

THE SUSHRUTA SAMHITA 

WITH 



A FULL AND COMPREHENSIVE INTRODUCTION, ADDITIONAL TEXTS, 

DIFFERENT READINGS, NOTES, COMPARATIVE VIEWS, 

INDEX, GLOSSARY AND PLATES 



IN THREE VOLUMES 



EDITED BY 

KAVIRAJ KUNJALAL BHISHAGRATNA, m.r.a.s. 

Vol. II. 

NIDANA-STIIANA, S'ARIRA-STMANA, CIIIKITv^ITA- 
^ .STIIANA AND KALArA-STIIANA. 



CALCUTTA: 
PUBLISHED BY THE AUTHOR, 

NO. 10, KASHI GROSE'S LANE 

I9II * 

AH Rights Reserved, 



PRINTED BY M. BHATTACHARYYA, AT THE BHARAT MIHIR PRESS, 
25, ROY BAG AN STREET, CALCUTTA. 



MAY 3 ?oni 



PREFACE. 



It is with mingled feelings of pain and 
pleasure that we now place before the public the 
Second Volume of our English Translation of 
the Susruta Samhita. The arduous task of com- 
piling a connected and succint history of any 
part whatever, of the ancient Hindu System 
of Medicine — requires greater leisure and more 
extensive reading than we can lay any pre- 
tension to. Years of patient study and constant 
discourse with our sainted preceptor the late 
lamented Mahamahopadhyaya Kaviraj Dwaraka 
Nath Sen, Kaviratna, that refulgent link of the 
golden'' . chain of the Dhanvan^aric succession, 
have enabled us, however, to grasp the leading 
facts, and during' thje.Iast few years we have 
worked contihutrusly^^n-moments snatched from 
the practice of an anxious profession that knows 
no respite, to arrange these facts in their present 
form. It breaks our heart to record the sad 
departure of our venerable Acharyya from this 
sublunary sphere to a land 'from whose bourne 
no traveller e'er returns.'* 

It is hardly necessary for us to reply to those 
critics who, through their ignorance of the original 



L^e.^^ 



( 2 ) 

Sanskrit works, persist in describing Ayurveda 
as an empirical system destitute of Anatomy, 
Physiology or Pathology in any scientific sense. 

It behoves us, however, in this preface to meet 
some of the charges which have been brought 
against us. 

Exception has been taken to our not includ- 
ing in the opening stanza the usual invocation 
to the Supreme Self (for a successful completion 
of the work) although it has found its way into 
almost all the printed editions of the work extant. 

Now the stanza referred to finds no place in 
the various manuscript copies of the original 
work which are in our possession, or on which 
we have been able to lay our hands. The work 
was first put into print by the late Dr. Madhu- 
sudan Gupta and we believe that it was only 
in this printed edition that the benedictory 
address in question appeared for the first time, 
and that it has since crept, by the process of 
circulation, into subsequent printed editions. 

In this opinion we are supported by the fact, 
that in none of the various commentaries and anno- 
tations on the Susruta Samhita is any mention 
made of the line in question, whereas, had it been 
the opening stanza of the original work, it would 
certainly have received at least a passing notice 
at the hands of the commentators, however easy 
or simple it might have been. Further, were it 
composed by Susruta himself, it would not have 



( 3 ) 

been in the form in which we find it in the printed 
editions. The ancient sages used invariably 
the auspicious expression "^^Tci:'^ or "^r^^'' 
and the like, when commencing a work and 
never invoked any particular deity for a happy 
termination of their undertaking."^ These are 
the reasons which have led us to omit the 
passage in our present translation. 

Another objection raised by a certain section 
of the community is that we should not have at 
all undertaken to translate the work into the 
English language. Their contention is that the 
Ayurveda, being an integral portion of the 
Eternal Vedas, should, on no account, be 
rendered into a Mlechchha Bhdshd and thus made 
accessible to the public at large, irrespective 
of caste or creed. 

Such an objection, at this time of the day, is, 
to say the least, most puerile ! Truth is truth, and 
latitudes and longitudes are not its boundary 
lines. The Vedas themselves have been trans- 
lated into many European languages. To keep 
the truths promulgated by our ancient sages con- 
fined within the coterie of the privileged classes 
and thus to deprive the educated public of the 



* Thus : — 

'a) "^ram'f fi^^^f^ffl^T'^z^Ts asTTUmr^:"— Charaka Samhita. 
(/;) *'^^T^ >^'W ^Ti^Mm:" — Kanada Vaiseshika Sutra 
(^) "^^T^ ^^fsr^T^T"— Vedanta Sutra. 



( 4 ) 

benefit of such truths would certainly be a 
sacrilege. In giving preference to English as 
the medium of translation we have been actuated 
by more reasons than one. 

It cannot be gainsaid that English has now 
become almost the lingua franca of the world, 
and to disseminate the ancient wisdom of India 
throughout the world, we could not have selected 
a medium better than the English language. 

Besides this, we have been actuated by the 
hope of drawing the direct attention of our be- 
nign Government to the scientific value of our 
system of Medicine by the adoption of such a 
procedure. 

Here we must not stop without expressing 
our sincere and hearty thanks to our learned and 
valued friends Kaviraj Jogindranath Sen, M.A., 
Vidyabhusana, Kaviraj Jnanendranath Sen, B.A., 
Kaviratna and Professor Satyendranath Sen, 
M. A., Vidyavagisa, who have rendered us material 
help in the publication of this volume. We must 
freely admit that but for the active and continued 
co-operation of the above-named gentlemen we 
could not have brought out this volume so 
promptly and successfully. Our thanks are also 
due to Dr. S. Sanyal, B.Sc, L.M.S. for his kind 
help, to Dr. S. N. Goswami, B.A., L.M.S. for 
his kindly supplying us with materials for writing 
the Introduction, and to our readers for their 
kind encouragement 



( 5 ) 

In conclusion, we implore our readers to 
excuse the errors of omission and commission 
which are inevitable in the execution of such a 
huge work, more especially when the author is 
encumbered with the responsible duties of his 
profession involving, as they do, the life and 
death of persons entrusted to his care. 



10, KASHI GHOSHE'S LANE,^ 

Calcutta. I KuNJA LaL BhISHAGRATNA. 

November^ igii, ' 



INTRODUCTION. 



In the introduction of the first volume of our translation 

of the Susruta-Samhita we have attempt- 

Ayurveda is not ed to place before the public a correct 
an Encyclopaedia .,^, _,. , „ . 

of ancient medical interpretation of Vayu, Pitta and Kapha, 

Mse on Biology!''^^^' ^^^ ^^^^^^^ so-called humours of the 
body* and it is a great pleasure to us, 
that our pronouncement has been very kindly accepted. In 
the introduction of the present volume we would draw the 
attention of the readers to the fact that Ayurveda is not at 
all an encyclopaedic work, — an Encyclopaedia of the Indian 

* Berdoe says :— "What is known as the Humoral Pathology formed 
the most essential part of the system of the Dogmatics. Humoral 
Pathology explains all diseases as caused by the mixture of the four 
cardinal humours, viz., the blood, bile, mucus or phlegm and water. Hip- 
pocrates first leaned towards it, but it was Plato who devoloped it. The 
stomach is the common source of all these humours. When diseases 
develop, they attract humours. The source of the bile is the liver, of the 
mufcus the head, of the water the spleen. Bile causes catarrhs and rheu- 
matism, dropsy depends on the spleen." 

Be it observed that among the humours of Hippocrates there is no 
place for Vata although in point of fact both his Physiology and Patho- 
logy are to be traced to the "Tri-dhatu" of Ayurveda. The secret of 
this anomaly is that the theory of Vata was found to be a complicated one 
and Hipprocates, not being able to comprehend its original import, left 
it out and cautiously introduced, in its stead, his own theory of "water". 
Sowe find "Humoral Pathology is not of Indian origin ; neither it is the 
same which the Indian Rishis of Rigveda developed under the name of 
Tri-dhatu." It is simply an imitation of Susruta who introduced blood 
( ^ [< !) ci-M<j^' i ) ^s the fourth factor in the genesis of diseases. Bui the bor- 
rower, in his interpretation of Susruta, had made a mess of it. He retain- 
ed blood, but substituted "water" in place of Vkta, the most important 
of the three, for reasons best known to him. 



il INTRODUCTION. 

system of Medicine in all its departments, but it is the 
Science of Life entire. 

Though it is customary and convenient to group apart 
such phenomena as are termed mental and such of them as 
are exhibited by men in society, under the heads of Psycho- 
logy and Sociology, yet it must be allowed that there are no 
absolute demarcations in Nature, corresponding to them, 
and so in the entire Science of Life, psychology and sociology 
are inseparably linked with Anatomy and Physiology, nay, 
more, with Pathology and Hygiene and above all with 
Treatment. In short the Biological Sciences must deal with 
whatever phenomena are manifested by living matter in 
whatever condition it is placed. Life in health ( ^^5: ) as 
well as Life in disease ( ^:?irTf: ), therefore, fall within the 
scope of Biology— even life exhibited by man in Society 
( f%cTTf%cf ) is not exempted from it. 

f^cnficf ^Ji -^'MM^i^^f f%mf%cT^ 1 

^^^ era ^5r^?TT#V. ^ ^'^ 11 '^T^, #^r^T, x^ ^'^m 1 

In calling Ayurveda, therefore, the entire Science of Life, 

Ayurveda, the "^^ ^'^ "°^ ^"'^^^ ^^ ^"^ prejudice 

entire Science of of our own, but we rely solely on 

^ ®* facts and figures, and these, when 

closely studied, will lead any one to arrive at the same 

conclusion, not unlike our own and to interpret Ayurveda 

as a collection of Biological Sciences in all departments. 

Ill the firs': place, for the guidance of our readers, we will 

mention that the name Ayurveda itself is a strong evidence 

in favour of its being called the Science 
Negative Eviden- ^r t -^^ o ji n c 

ces thereof:— Of Life. Secondly, we will refer to 

I. The Name it- (\^q arrangement of the subject-matter 

in the Sarira-sthana which is popu- 
larly belived to be the anatomical portion of the book, as 

tending to the same conclusion. In 

II. The arrange- .. . . . .... ., 

ment of the sub- this section, chapters on Midwifery 

ject-matters. ^nd Management of Infants follow 

close to the heels of those on Anatomy and Physiology, and 



INTRODUCTION. iH 

these latter again are immediately preceded by chapters 
on Psychology. This intermixture is certainly an anomaly 
and can in no wise be satisfactorily explained unless we 
have to look upon these as general truths of Biology, 
elucidated by the Introduction of special truths exclu- 
sively collected from the science of medicine — fviw^rrf^^ ^^T^ 
4j»<[Mlci i f* f I To. call it Descriptive Anatomy or Physiology, 
in the modern sense of the term is simply ridiculous. The 
absence of any reference to brain and 

Want of Descrip- spinal cord, to pancreas and heart, in 
tive Anatomy and ^ > f » 

Physiology in the a book of Anatomy and Physiology is 

Ithlnaitself^-^"^^" unpardonable and in the Sarira-sthana 
we feel this absence almost to despon- 
dency. Moreover, in western medical science, Grey's Ana- 
tony and Kirke's Physiology, for instance, in their bulk, 
exceeds, each, more than a thousand of pages and to present 
to the public, under the same name less than half a dozen 
of pages, as the result of Indian wisdom, is certainly a very 
miserable contrast — a contrast that is calculated to inspire 
no admiration, but, on the contrary, to generate in scientific 
minds an universal apathy, at least an apathy towards all that 
is connected with the system of Indian Medicine. In order 
to save our venerable Rishis from this disastrous plight, we 
announce here foremost of all, that our beloved Science 
of Ayurveda is by no means an Encyclopaedic work, but 
distinctly possesses every characteristic 
ces°^'*'''® ■^'''^®''" that "^a^^s the Science of Biology. 
I The definition The very name Ayurvada indicates 
Same as Life as that it is actually a science of Ayus 

same sense as Mr. Herbert Spencer 
understands by his remarkable definition of Life. 

In liis masterly classification Mr. Herbert Spencer has, 
in his Biology, given, indeed, the first place to Anatomy and 
Physiology, but still it is divested of any elaborate chapters 
dealing with the subjects. 

B 



IV INTRODUCTION. 

In the science of Life a short reference to the structures 
of the body or its functions is quite sufficient to illustrate 
its principles, and if we fail to find therein any discourse on 
the descriptive Anatomy and Physiology, we still consider 
that there is nothing amiss. 

But unfortunately the fate of Ayurveda is otherwise. 
Though the very name indicates that it is Biology pure and 
simple, still it is denounced for its dificiencies in Anatomy 
and Physiology, and doomed for ever. 

Sanskrit words are notorious for their confusion of 
meanings, but, as regards Ayurveda there exists no difference 
of opinion, at least, so far as the first word is concerned. 
Ayus is Ayus everywhere in Ayurveda and it is the only fault 
our venerable Rishis may be reasonably charged with, that 
they did not put themselves into any great trouble to 
explain Ayus, but, on the contrary, unlike scientific men, 
misspent their energy to ascertain the significance of the 
insignificant portion of Ayurveda, that is the meanings of the 
root "F/^a" in the light of Grammar. 

The scientific ear, ever unsatisfied with these grammati- 
cal eruditions, has ultimately thrust an Encyclopaedic value 
upon what is properly speaking, a book of Biology. Of course, 
there is a marked difference between the two. An ordinary 
treatise on Biology deals with the general truths of life, 
and does not represent, by way of illustrations, all its special 
truths, nor their practical sides, but so far as Ayurveda is 
concerned, the general truths of Biology are thrown into the 
background and the special truths, gleaned exclusively from 
the science of medicine, are given great prominence (fir^^irf^ 
^T^ ^^^f^cnf'T ), so much so, that it is now regarded 
as a system of Medicine and Surgery which has neither 
Biology, nor Anatomy, nor Physiology, nor Pathology — but 
is a systematised Empiricism or Quackery. This is certainly 
a great misfortune. Apart from the name, the arrangement 
of the subject, to which we have just referred, at least, in 
the section of Sarira-sthana (the falsely so-called Anatomy of 



INTRODUCTION. V 

the Hindus), — is a direct contradiction to its bieng considered 

as an Encyclopaedic work. The existence of the chapters on 

midwifery and management of infants in the same, following 

immediately the chapters on Anatomy, serves as a strong 

additional evidence thereof. It is an anomaly no doubt, 

that Midwifery has been offered a place in the section of 

Anatomy, but the confusion does not 
Reasons for in cor- . . ,, t j j -r i j. 

porating Midwifery get at all confounded, if we are led to 

into this Anatomi- believe that the science of generation 
cal section. ^ 

of a superior race (if we are at all 

permitted to use the term) forms, indeed, an important depart- 
ment of Practical Biology. 

From whatever standpoint we look to the question, we 
find there are grounds to lead any one to pronounce in 
our favour and to come to the conclusion at which we 
now venture to arrive. Besides these two important facts, 

we now cite the following passage as 

Internal evidence. ^ • . i j • r c 

a strong mternal evidence in favour of 

our view. Maharshi Punarvasu, after giving us a short table 

of the principal structures of the human body, remarks that 

even this reference is considered by many as superfluous, 

Reasons for omit- ''^ '^^ S'°"°^' ^^^^ ^" acquaintance 
ting Descriptive with the molecular construction of an 

organism is quite sufficient to help us 

as a reliable guide to treatment. 

The passage referred to is quoted below : — ■ 

Now we ask the reader if this is not a sufficient evidence, 
proving to the hilt, that Ayurveda is nothing but Biology 
and that we run no risk of committing a grave omission if 
the chapter on Anatomy is wholesale dispensed with from 
Ayurveda. For the improvement of this awkward position — 
that in the section of Anatomy there should be no Anatomy 
^-Ihe entire credit is due to Susruta, as he has very wisely 
made the suggestion, that a knowledge of the anatomical 
structures of the body is of great value, at least so far as it 



VI INTRODUCTION. 

helps the Surgeons and the Surgeons only in their operations.* 
But so far as Biology is concerned with medicine, Susruta 
does not forget to lay particular stress on the knowledge of 
the molecular construction of the body. The following 
memorable passages actually preached by this renowned 
Surgeon, some three hundred centuries ago, still stands as a 
model from which modern Science, even in its present ad- 
vancement, can draw inspirations. 
He says : — 

I. T ^^^l^T 5^' tf \^cPH\ f%H*. I 

^^cTT'^it ^^'^'T^T^'giT'^^ff fen: II 

IT<5m^ f% ^^ ?^ ^Ml^^ Wtrl I 

^RRTcT^^^ ^ '5TTf%^Tii[ II 

That is, the protean work of the protoplasm in which the 

great Self resides cannot be detected by the body's eye ; to 

know its work, mind's eye is necessary, along with the body's 

eye. For acquiring efificiency in Surgery alone, the dissection 

* Susruta recommends dissection on dead human bodies and suggests 
that it is only required of those who will practise surgery and that students 
of medicine can do without it. Herophilus practised dissection on 
living bodies and with the object of practising medicine successfully, 
but it soon fell into disrepute and did not at all influence the art of 
Medicine.! He was condemmed even by his own pupil Philinus of cos 
who declared that all the Anatomy his vivisecting master had taught him 
had not helped him in the least in the cure of his patients. Such 
indeed was the fate of vivisection for which Europe now takes pride. 

But Susruta's, Avagharskana is now considered by many as the only 
perfect mode of dissection ever known. It is with the help of this 
method of dissection that the layers of epidermis and dermis could be 
discovered and blood-vessels with their minute branches could be counted 
to be as many as thirty millions. Not only this, but also in the opinion of 
several European savants, Susruta still stands as a model of surgery and 
European surgery has borrowed many things from Susruta and has yet 
many things to learn. 



INTRODUCTION. Vll 

of dead body (not of living body as proclaimed by 
Herophilus), nay, the Avagharshana which brings into view 

The knowledge ^^^ ^^^^^^ °^ ^^^ epidermis and the 

of the Molecular dermis, the number and branches of 

Construction of the ., , , , , ,. , -, 

body is all that is blood-vessels and nerves that lie embed- 

wanted. ^^^ j^ muscles, etc , is only necessary. 

Professor Michael Foster's remarks in his article on 
Physiology in the Encyclopedia Britannica, to all appearnces, 
are just in the same line, if not identical with our extract, 
when he says **that the problem of Physiology, in the future, 
is largely concerned in arriving by experiment and infer- 
ence, by the mind's eye, and not by the body's eye alone, 
assisted, as that may be, by lenses yet to be introduced 
at a knowledge of the molecular construction of the protean 
protoplasm ; of the laws according to which it is built up 
and the laws according to which it breaks down ; for these 
laws when ascertained will clear up the mysteries of the 
protean work which the protoplasm does." 

Ijo short the knowledge of the molecular construction of 
the body is just the thing with which Biology is concerned, 
and such is the unanimous verdict both in the East as well as 
in the West, in the most ancient and in the most modern 
Sciences of the world. Now, if the 'knowledge of the molecular 
construction of the protoplasm, of the laws according to which 
it is built up, and the laws according to which it breaks down,' 
is all that is necessary for an accurate knowledge of Anatomy 
and Physiology, our Ayurveda is pre-eminently the Science 
we want. 

The following extracts, from Charaka Samhita, are cited 
here to prove that we are quite justified in our contention. 

2. ^fl?:^icrTt ^ % ^%^^5mt fir^^ 1 

That is, the body is composed of molecules and these are 
said to be numberless, because no body can count them up. 



Vlll INTRODUCTION. 

By their union, they build up the body, and this union is 
governed by three Laws, viz., the Laws of Vayu, Karma and 
Swabhava (which are almost equivalent to the three Biological 
Laws, Z^., the law of heredity, the law of external relations and 
the law of molecular motion caused by Ethereal vibrations 
compared with which nerve-impulses — akin to electric force, — 
are grosser and coarser shocks). So far we think we have 
proved that Ayurveda, as a Biology is not defective, if it 
contains no descriptive Anatomy and Physiology— descriptive 
in the same sense as Grey's Anatomy or Kirke's Physiology is. 
Its Histiology is molecular; its Pathology is molecular ; its 

Physiology is molecular. Molecular in every sense is 

the Biology of the Hindus. Virtually speaking, Ayurveda is 
our Science of Life, and we will presently shew that Lije 
and Ayus are identical. 

The continuous adjustment of molecules, their successive 
breaking down and building up within an organised living 
body, without destroying its identity, is the definition of Ayus 
as suggested by Maharshi Punarvasu. 

He says :— 

In another place the same definition is repeated with a 
slight modification and in this he enumerates ^TTT^ff^:, 

(consciousness) as the most distinctive 
of'Ayu. ^^^'^^^^^^ characteristic of ^I'wj. According to this 

definition, aifl^f^^r^imMT: and %i^Tg- 
?t^: re'er to an organised living body ; f^^: and '^ig^^: are 
identical with processes of breaking down and building up of 
the organism without destroying its identity. The idea of 
continuous adjustment is included also in these two words. 
So we find, the definition oiAyus^ as sugessted by Punarvasu, 

includes more than what is proposed in 

The same as Life, x/r tt u .. c > j /- •.• t t -x 

Mr. Herbert Spencer's definition oi Ltfe. 

The words ^ilr and eftf%?TiT, as explained by the great annotator 

Chakrapani, represent two more distinct phases of Life, the 




INRODUCTION. IX 

first bearing upon the cistence in the system of a preven 

tivefactor of putrefaction, the second 

More compre- ... , , 

hensive than Life PO'»'"g ^^ the agent or agenr. hat 

as defined by Mr. adjit the internal relations 
Herbert Spencer. 

catttouche?, which professor 

Foster speaks of as "contiuously passing from protop 

protoplasm and compared/ith which the nervous 

^ „ „. , , (whih are perhaps electrical in 

Prof. Michael ^ , 

Foster on the The- are rosser and coarser shocks. ' 
ory of Sensation. ^^-^^^^ ep'ahei, viz., "^^lf^/' as em 

plained by Chakrapani — t^I^?^ mWT*[ ^TT^fw^'— furnishes us\^ 
with a clue to determine wat Ayus ( ^[^: ) actually means. 
Our Sacred Upanishads now come for- 

J Upa^n'fste °^ ""-^^ °"' '^"«f ='"d '«" "'■ '" 'he first 
place "^g: flTC" ie , Ayu and Prana 
are one and the same prinole. In the second place, "?[: im: 
^ ^:", i.e , Prana and Vdy are identical. In the third place, 
'% 1^ ^^?i ^fTT^n^'n'RT:",?'.^., Vayu is not unlike Ether. 
In the fourth place, '^T3 ^-^^t w", i.e,^ the primitive fluid 
^according to Lord Kelvin)^ divided into two parts, viz., — 
without motion, another edued with motion. In the 
place, "^4f%«5in^if\ />., everything in this world 
waves of this Ether enduecwith motion. In the sixth pi 
"^rg^ ^*^:" "^gx^ t%, W m^g", ie., Vayu is the univei-.^. 
store of energy ; in the Phjical world it is known by the 
name of Vayu ; in the Liing world it is called under a 
different name and that nam is Prana (mw.) 

From the above short tab we come to know that the 
agent that adjusts the internl relations to external relations, 
is Ayus and that Ayus is Liftand that Life is a motion of the 
great etherial fluid which is kown in Sanskrit as ^'is" and that 

*'^T^^ is the sum of all the various 
The same as pri- . . • , • , j . • i • , 

mitive fluid as de- energie— biological and abiological— 

fined by Lord which nder the name of heat, light, 

Kelvin. » 5 I 

electricy or consciousness, etc., manifest 

themselves both in the Physiil as well as in the Metaphysical 




^ 



X INTRODUCTION. 

world, and that Prana (vm',) is another name of the same force 
that, in acting on an aggregated living body, divides itself 
into five distinct forces, viz.y Prdna, Apdna^ Samdna, Uddna^ 
and Vydna, and subserves the functions of correlation ( ^rgt ) 
and sustentation ( f^ ) and controls oxidation (^^). So 
Prana continuously helps to adjust, like the main-spring of a 
watch, the internal relations to the external relations. We are 
indebted to the master mind of Sankara for his able exposi- 
tion of the functions of this main-spring, 
vJyu a5dlth7r. "^ ^^at is, of the etherial vibrations (mgiiro:) 
as transformed into the vital force in 
an organised body. We quote below what he says about it 
in his celeberated commentary on the Vedanta Darsana. 

The five divisions -s _-. _c 

of V^yu in its ac- 'H^* ^^ ^^"^ ^'^ '^ cf^T^^ STTST^ ^f- 

tion on a living ^^^ , ^fc^^w ^ w^w^ ^ ^ fw-^ I 
aggregate. 

That is, the primitive fluid that is endued with motion in its 
evolution of Life gets knotted into five divisions, viz , Prdna, 
Apdna, Samdna, Uddna and Vydna, and this acting on any 
aggregated living matter is called Prana. So what we call 
Prana is not the Vayu itself, but a particular mode of its 
motion. Hence the question of identity and non-identity is a 
matter of choice. Shortly speaking, this is the Biology of 
the Hindus. This too is the sum and substance into which 
(as a department of Biology), Physiology unfolds itself. 
This too evidently serves as the line of 
Biology forms the demarcation between ^TfT^: and ^'.^j:, 
^^fl'n^T^evllopel f^: -^ ^fwj. From this too 
as so much col- Health and Disease, Hygiene and 
lateral branches. r^,^^^^^^^^ Psychology and Sociology 

have all their origin and start. In fact. Biology forms the basis 

upon which the great edifice of the Indian Medical Science, as 

a collateral branch, has been developed. 

Conclusion. ^j^g general truths of Biology a e all 

there in the Ayurveda ; but the special truths from medicine 



INTRODUCTION. XI 

have been given so great a prominence that the real character 
of the book has been over-shadowed and it has been trans- 
formed into a Science of Medicine. 

******* 

With a view to convey to the minds of our readers 
an idea of the different branches of the Medical Science 
which developed as a'collateral branch of this great Science of 
Life, we would here touch upon a few of them in passing. 

Magnetism had formed its way into the therapeutics of 

the ancient Hindus and animal magne- 

Masnetism. . , • , . 

tism was very extensively practised in 

India long before they were recognised by Mesmer in Germany 

and subsequently by John Elliotson in England. 

The Indian writers on Medical Science of the good 
old days have described in length the 
medicinal properties of the waters of 
the principal rivers, lakes, water-falls and mineral springs of 
the country that were known at the time and their respec- 
tive curative powers as applied to various ailments that 
human flesh is heir to. This goes a long way to establish 
the fact that Hydropathy was known in India long before 
it was even dreamt of in the Western world. 

The ancient Hindu sages from time immemorial had 
been cognizant of the benefits of 

assage. massage and shampooing and taken 

to practising them. Whereas, it is but of late that the 
advantages of these methods have begun to be appreciated 
by the Western Medical School and it no longer hesitates 
to acknowledge them as efficacious therapeutic agents. 

The Science of begetting healthy and beautiful children, 

which is just beginning to receive atten- 
Genesiology. ... 

tion m other countries was not un- 
known to the ancient Hindus, and Manu in his Mdnava- 
dharma-Sdstra has laid down special injunctions which still 
form an integral part of the domestic life of the orthodox 
section of the community. As a matter of fact, they knew 

C 



Xll INTRODUCTION. 

that mental impressions of the parents at the time of con- 
ception exercise a great influence over the future destiny 
of the child in embryo. 

Thus we read in the Sastras : — "A woman^ though at a 
distance, conceives a child of the shape of the person she 
loves ardently and thinks of at the time. Just as a tree that 
grows is not different from the parent tree whether we plant 
a branch or sow a seed, so the main features of the child 
partake of the features of its father, though there might be 
slight changes due to the soil." 

The subtle soul co-operates with the Manas (the mind) ; 
the mind co-operates with the senses ; the senses perceive 
objects 3 all this takes place in little or no time. The above 
is the connection between the soul and objects around us. 
What is there which the mind cannot comprehend ? There- 
fore, wherever the mind enters, the soul follows it. 

"The soul being subtle, whenever it enters another soul, 
requires some time and an effort of the mind to know the 
latter. The soul, which intensely meditates on an object, 
assumes the shape of that object.'' etc, etc. 

In a book entitled Bhoja-Prabandha being a collection 

of the anecdotes realating to the reign 

Anaesthetics. ^^ ^^^^.^ p^^.^^ ^^ Pandita Ballala 

there is narrated the detail of an interesting surgical opera- 
tion which had been performed on the Raja, who was suf- 
fering from an excruciating pain in the head. All the 
medical aid obtaining at the same time was availed of, but 
in vain and his condition became quite critical when two 
brother physicians accidentally arrived in Dhar, who were 
duly called in. These physicians, after carefully examining 
the patient, held that unless surgically treated no relief 
could possibly be afforded to the Royal patient. Accordingly 
they administered an anaesthetic called Sammohini with 

* F/V/.?— -Baraha Mihir's Brihat Samhil^ Book, II. Chapter Ixxv- 
Verses 1-3. 



INTRODUCTION. XUl 

a view to render him insensible and, when completely, 
under the influence of the drug, they trephined his skull, 
lemoved the malignant portion of the brain, the actual seat 
of the complaint, closed and stitched up the opening and 
applied a healing balm to the wound. Then they adminis- 
tered a restoration known as Sanjivani to the patient, 
who, thereupon, regained consciousness and felt quite at 
ease. This incident (as narrated by Thakur Saheb 0/ 
Gondal in his Short History of Aryan Medical Science) 
goes to prove that the attendant physician of Buddha, is 
likewise recorded to have practised cranial surgery writh the 
greatest success. Instances of successful cases of abdominal 
section are also not rare. Thus it will appear that the ancient 
Indians knew and successfully practised surgical operations 
which are regarded now-a-days as the greatest triumphs of 
modern surgery. Tiie purpose of chloroform in the palmy 
days of yore was used to be served by Sammohini, but 
there is hardly a drug known to modern Pharmacopaeias, 
corresponding whith Sanjivani which certainly lessens the 
chances of deatlis that at present sometimes occur under 
anaesthetics. .. ^ 

Let them, who allege that the Hiudu system of the heal- 
ing Art is unscientific, now pause and reflect ere they make 
such an unwarranted and irresponsible assertion. How can a 
system which contains so accurate an account of the unions of 
bones and ligaments, anastomoses of nerves, veins and 
arteries, etc , and which assures the world of the existence of 
three crores and a half of veins and arteries in the human 
body giving facts and figures thereof with such mathe- 
matical precision, be regarded as being unscientific ? 

It is certainly an undeniable fact that one of the colossal 

achievements of modern Western Medical Science is its 

Anatomy; but the point at issue is whether the process of 

laying open the structures of the body 

issec xon. with the lancets, is at all a satisfactory 

method. For, is it not a fact that the finest and the 



XIV INTRODUCTION. 

minutest arteries of the skin are never disclosed, if the scalpel 
is used so recklessly to remove the skin all at once and 
not allowed to go deeper into the muscles to expose the 
minute branches of blood vessels and nerves that may happe i 
to lie embedded therein ? But, on the contrary, look at the 
process promulgated by Susruta for demonstrating practical 
Anatomy ! Its originality and perfection beats hollow all 
the known methods, although it was discovered in almost the 
pre-historic age. The process prescribed by the Hindu 
system is as follows : — Cover a dead body with Kusa grass 
and place it at the edge of the water of a rivulet. After 
three days take it out carefully, and gradually take off 
the succsesive layers of the epidermis and dermis and 
of the muscles beneath by gently and lightly rubbing it over 
with a soft brush. Thus the smallest and the thinnest 
arteries, which have by this time swelled and obtained a 
distinct existence are made palpable everywhere even to 
the minutest. 

The process is termed, as we have pointed before, Ava- 
gharshana by Susruta. The Western method might be an 
^ easier and a more off-hand one, but by no means precise. 
Though the merit of discovering this mode 
Avagharshana. ^^ dissection is due to Susruta, we are all 
blind to it and call Hippocrates the father of Medicine ! It is 
generally believed that with a view to further his researches 
and perfect his knowledge, it is Hippocrates who inaugurated 
the system of dissection of dead human bodies and he did 
the work secretly. Credulous people may lend a willing ear 
to such assertions but the fact is, that it was not till a century 
later that Hirophilus openly resorted to dissection of 
human bodies and thereby earned an undying fame in 
Europe, obliterating Susruta's name for ever, though, virtually 
speaking, he (Susruta) was the pioneer of dissection and 
figured in the world more than a millenium before the 
advent of Hippocrates and over eleven centuries prior to tb$ 
age of Herophilus^ 



INTRODUCTION. XV 

It would not, perhaps, be out of place here to mention 
that Dr. A. F. R. Hoernle, M. A , F. R. S , C. I. E., Ph. D., 
in his recent publication on Hindu Osteology, has proved it 
to the hilt, how systematic, scientific, unerring and exact were 
the researches of the ancient Hindus and what a mine of 
resplendent truths lay imbedded in them ! We, in our Intro- 
duction of the first volume of this work, have tried to prove 
how very superb, salutary and supremely happy was the theory 
of Vayu, Pitta, and Kapha promulgated by Susruta. There 
we have incidentally mentioned that the Science of Embryo- 
logy was not unknown to the Hindu sages. In the present 
volume we mean to prove to a point that the main principles 
promulgated in the Anatomy, the Physiology and the Patho- 
logy of Susruta yield in no way to the principles on those 
subjects included by the modern Western Scientists and 
investigators. On the other hand, we boldly affirm that in the 
theories propounded by Susruta some two thousand years 
back there lies a fund of truths which might well throw a flood 
of li^ht on the field of labour of the modern scientific men of 
the West. For is it not a fact that the theories of Vamana 
(causing to eject the contents of the stomach by mouth), 
Virechana (causing the evacuation of the intestines), Nasya 
(causing to inhale through the nose), Anuvdsana and Asthd- 
fana which, in ancient India, had earned the appellation of 
Pancha-Karma, and had gained universal prevalence, and were 
extensively practised by oriental physicians from time im- 
memorial, have, of late, been hailed by the medical authorities 
of the day as the most approved and commended mode of 
treatment. 

Sceptics who care nor to examine and weigh solid facts, 
bluntly allege that the Ayurvedic system is not based 
upon experiment and observation — the keystone of all 
true Science, and such being the case its Anatomy, Physio- 
logy, Pathology and Therapeutics are all erroneous. The 
suggestion, cruel and baseless as it is, originally emanated 
from an eminent Indian physician who has earned an un- 



XVI INTRODUCTION. 

enviable reputation by writing a Treatise on Hindu Materia 
Medica. He says : — *'It (the Ayurvedic system) is built not 
so much upon experiment and observation as upon an 
erroneous system of Pathology and Therapeutics.*' But such 
an expression would not stand the light of day. Indeed 
none but the ancient Hindu sages did set a high value on 
experiment and observation, and where they did not claim 
some occult knowledge or intuition, it is upon these two that 
they mainly based all their knowledge. 

The Materia Medica of the Hindus is really a marvel. 
Its description of the properties of drugs belonging to the 
animal, vegetable and mineral kingdoms, and of the articles 
of food essential to the maintenance of health and strength, 
its selection of the specific dietaries and elimination of what 
are prohibited in particular ailments are every day being 
found correct. The European preparations of Indian drugs 
and diets are corroborative evidence thereof. The theory 
adopted by the ancient Hindus as the basis of their investiga- 
tion is that every substance, whether regitable or animal, 
possesses five properties namely, — Rasa, Guna, Viryya, Vipaka 
and Prabhava which lenses alone cannot reveal, nor the body's 
eye after observation and experiment made upon rats and 
rabbits. And those who have opportunities of studying and 
practising both the Eastern and Western Medical Science 
assert that the ancient Medical Science of the Hindus once 
reached the highest standard of excellence and perfection in 
Materia Medica, Therapeutics and Hygiene and was simply 
unrivalled and unapproachable, as it blended Philosophy with 
Science— the mind's eye with the body's eye. 

A dispassionate examination of these facts (and such as 
can be multiplied to any extent), will convince an impartial 
reader that Ayurveda, as we find it described in Charaka 
Samhita and Susrula Samhita, if approached in a spirit of 
fairness and enquiry, might reveal the germs of not a few 
of the marvellous achievement of the present age in the 
domain of Medical Science and afford to the assiduous 



INTRODUCTION. XVll 

Student a vast scope and varied materials for comparision 
between the Eastern and the Western systems, and render 
material help in improving upon the one with the aid of 
the other, and this to the benefit of the suffering humanity at 
large. 

Lastly it is our prayer, that if Western Medical Science 
was ever anywise, directly or indirectly, benefited by the 
ancient Medical Science of the Hindus, it is but meet 
and fair that the former should come forward to render all 
possible aid to her parent Science, and that as it is almost 
dying now for want of aid and succour we look hopefully to 
our present benign Government in whose power lies the 
means of its complete regeneration. 



PLATE No. I. 




Vital points (Marmas) in the arm 
(inner side). 



Vital points (Marmas) in the arm 
(ouVer side). 



'J" indicates the points recognised in Juijutsu. 



See Chapter VI, S'arira-S'thana. 



PLATIO No If. 




Vital points (Marmas) in the leg ' Vital points (Marmas) in the back 
(outer side). j of the thigh and the leg. 

**J" indicates the points recognised in Juijutsu. 



See Chapter VI, S'arira-Sthana, 



CONTENTg. 



NIDANA STHANA. 

(Sect/on on Pathology). 



CHAPTPR I. ^ , 

Diseases of the Nervous System, etc :— The action of the V.-tyu 

in its normal state. — The Prana V^yu— The Udana Vdyu — The Samana 
V^yu — The Vy^na V^yu — The Apana Vdyu. — Descriptions of the nature 
of the diseases — When they are localised in the different parts of the system. 
— Pathology of Vatta-rakta — Its premonitory symptoms — Its prognosis. 
— Spasms — Convulsions — Epilepsy without Convulsions — Epilepsy with 
Convulsions. — Hemiplegia — Its Prognosis. — Wry-neck or Torticollis. — 
Facial Paralysis — Its Premonitory Symptoms — Its Prognosis. — Sciatica. — 
Erb's Paralysis. — Synovitis of the Knee-joints. — Lameness. — V^ta-Kantaka. 
— Pada-D^ha — Pada-Harsha. — Ams'a-s'oshaka. — Ear-ache. — Deafness. — 
Nasal voice. — Indistinct Speech. — Tuni — Prati-tuni. — Tympanites. — Vata- 
shthili,— Pratyashthila. ..» ... • ... Pages 1—17. 



CHAPTER II. 

HsemorrhoidS : — Classifications — Patholog>'— Premonitory Symptoms. 
— VatajaType — Pittaja Type — Kaphaja Type — Raktaja Type — Sannipataja 
Type — Congenital Type. — Figwarts or condylomatous growths about the 
genitals.— Prognosis. .,'. ... ... ... 18—24. 



CHAPTER III. 

tJrinary Calculii ;— General Etiology. — Premonitory Symptoms.— 
Leading Indications. — S'leshmaja As'mari — Pittaja As'mari— Vataja As'mari. 
—Seminal Concretions.— Supervening Symptoms.^ — Situation of the Blad- 
der*-— How stones are formed in the Bladder. ... ... 25— 30' 



CHAPTER IV. 

Fistula-in-ano cand Fistular Ulcers :— Classifications— Premonitory 
Symptoms.— Derivation of the term Bhagandara.— Vataja Type— Pittaja 
Type— Kaphaja Type— Sannipatika Type— Traumatic Type— S'ata-ponaka 
Type— Ushtra-griva Type— Parisravi Type— S'ambukavarta Tppe— Un- 
margi Type.— Fistulous Pustules.— Prognosis. ... ... 3i~34' 



CHAPTER V. 

Cutaneous Affections in general:— Premonitory Symptoms— 

/Etiology — Classifications. — Aruna-Kushtha — Audumbara — Rishya-jihva 
— Kapdla Kushtha (Macula).— Kakanaka—Pundarika—Dadru (ring-worm) 
— Sthularushka— Eka-Kushtha ( Ichthyosis)- Charma-dala (Hypertrophy of 
the skin) — Visarpa-Kushtha — Parisarpa-Kushtha — Sidhma— Vicharchika 
(Psoriasis)— Vip^dika—Kitima (Keloid)— Pama (Eczema)— Kachchhu— 
Rakasa (Dry Erythema) — Kilasa. — Congenital cause of Kushtha. — 
Prognosis. — How Kushtha becomes contageous. — Some other contagious 
diseases enumerated. ... ... ... ••• 35 — 42' 



CHAPTER VI. 

Diseases of the Urinary tracts :— Pathology— Premonitory Symp- 
toms. — General characteristics. — Kaphaja Type — Pittaja Type — Vataja 
Type. — Names and Symptoms of Kaphaja Meha — Sura-meha — Lavana- 
meha — Pishta-meha — Sandra-meha — S'ukra-meha. — Names and Symptoms 
of Pittaj a Meha — Nila-Meha — Haridra-meha — Amla-meha — Ksh^ra-Meha 
— Manjishtha-meha — Rakta-meha. — Names and Symptoms of Vsttaja Meha 
— Sarpir-mcha — Vasa-meha — Kshaudra-meha — Hasti-meha. — Supervening 
Symptoms. — Kaphaja Types — Pittaja Types — Vataja Types. — Abscesses. — 
Carbuncles. — Pimples. — Pustules, etc., due to Prameha. — Prognosis. — 
Symptoms of Madhu -Meha. .. . ... ... ... 43—49. 



CHAPTER Vn. 

Dropsy with an abnormal condition of the abdomen: — Classifications. — 
t»redisposing causes.— Premonitory Symptoms.— Vataja, Pittaja and 
Kaphaja Types.— Tridoshaja Type. — Enlargement of the Spleen and the 
Liver with dropsy of the AMomen. — Vaddha-gudodara — Parisrdvi-Udara. — 
Jalodara (Ascites). — General Characterstics of Dropsy. —Prognosis. 50 — 54. 



Ill 

CHAPTER VIII. 
False Presentations and Difficult Labour -.—Causes.— Definition. 

— Classifications and Symptoms. — Abortion. — Miscarriage. — Prognosis. 

Csesarian Section. • • • •• ■•• 55— 60. 



CHAPTER IX 

Vidradhi (Abscess, etc.) '• — Definition and Classification— Vataja, 
Pittaja and Kaphaja Types— Sdnnipdtika Type— Traumatic Type— Ivaktaja 
Type— Incurable type of External Abscess.— Internal Abscesses— Their 
localities.— Differentiating diagnosis of Gulma and Vidradhi. — Incurable 
Type . ... •■• .-. ••• .-. 61 — 66, 



CHAPTER X. 
Erysipelas, Sinus and Diseases affecting the mammary glands 

of women •• — Definition of Erysipelas — Vataja, Pittaja and Kaphaja Types 
— Sannipatika Type — Kshataja Type.— Prognosis. — Nsidi-Vrana (Sinus). 
— Classification — Vataja, Kaphaja and Pittaja Types — Dvandvaja and 
Tri-doshaja Types— S'alyaja Type.— Stana-roga.— Breast-milk— Its 
character — Its normal and abnormal traits. — Stana- Vidradhi (Inflammation 
of mammary glands). ... ... ... ... 67 — 71. 



CHAPTER XI. 
Glands, Scrofula, Tumours and Goitre :— Dosha-origened Glands 

— Sirdja gland (aneurysm or Varicose Veins). — Apachi (Scrofula* etc.) — Its 
symptoms. — Tumour — Its symptoms — Blood-origined Tumour. — Mamsa- 
Arvuda. — Prognosis. — Adhyarvuda. — Dvirarvuda. — Cause of its not being 
suppurated.— Definition of Goitre— Its specific Symptoms— Vataja 
Goitre— Kaphaja Goitre — Medoja Goitre.— Prognosis.— General shape of 
Goitre.— ... ... ... ... ... 73—78. 



CHAPTER XII. 
Hydrocele, Hernia, Scrotal Tumours, Upadamsa (disease of the 

ginital organ) and Elephantiasis:— Classification of Vriddhi — Definition 
and Premonitory Symptoms of Vriddhi. — Symptoms of Dosha-origined 
Vriddhi.— Medoja Vriddhi — Raktaja Vriddhi— Hydrocele. — Inguinj^I 



IV 



Hernia.— Upadams'a— Symptoms of. different Dosha-origined types of 
UpadamSf'a.r— Raktaja Upadams'a.— -Definition of Elephantiasis. — Causes 
a,ncl Symptoms of different kinds of Elephantiasis. — Prognosis of Elephan- 
tiasis. — Localisation of Elephantiasis. ... ... ... 79 — 84. 



CHAPTER XIII. 
l^iseases known by the general name of Kshudra-Roga (minor 

ailrnents):— The Names ?ind Symptoms of the diseases included therein. — 
^jagallika— Yava-prakhya — Andhalaji — Vivrita— Kachchhapika — Valmika 
^— indra-vriddha— Panasikd— Pashana-Gardabha- Jala-Gaiddabha— Kak- 
sha— Vishphota — Agni-Rohini — Chippa — Kunakha— Anus'ayi — Vidarikd— 
S'arkardrbuda — Pama — Vicharchikd — Rakasa — Pdda-ddrika — Kadara — 
Alasa — Indra-lupta (Alopecia) — Darunaka — Arumshika— Palita— Masurika 
etc. — Tila-kalaka — Nyachchha— Charma-kila — Vyanga— Parivartika— Ava- 
patika — Niruddha-Prakas'a — Niiuddhat-guda — Ahi-putana — Vrishana- 
^achchh^— Guda-Bhrams'au ' . j .. ":. '\, :,:' ... • • • 85—93. 



CHAPTER XIV. 

■' Sukdi-dbSh,a:--^Its classification.— Symptoms of different Types. — 
iProgonsis. ... ..' ... ... .••94 — 9^. 



CHAPTER XV. 

Fracture and Dislocation, etc -.—Their Causes.— General features 
of Sandhi-mukta (Dislocation). — Diagnostic Symptons of Dislocation. — 
TWfferent -kinds of Kanda-bhagna (Fracture) — General, symptoms of Kanda- 
'bhagna. — Curable and incurable Types, ... ... ... 97 — ioq. 



CHAPTER XVI. 

Mukha-Roga (Diseases which affect the cavity of the mouth in 
general).* — General Classification and Localisation. — Diseases of the lips. — 
Dosha-origined Types. — Raktaja Type— Mangsaja Type — Medoja Type 
— Diseases of the roots of the teeth.— Their Names and specific Symp- 
toms.— Danta-Nstdi (Sinus at therootof a, tooth).— Diseases of the tooth 
proper. -^Their Names and specific Symptoms. — Diseases of the tongue — 
Their Names and specific Symptoms^ — Diseases of the Palate— Their 
Js^mes and specific Symptoms.— Diseases of the Throat and Larnyx 



. — Their Names and specific Symptoms. — The different Kinds and Symp- 
toms of Rohini,— Diseases in the entire cavity. ... ... loi — III. 

End of the contents of Sutra-stlisina. 



SARIRA STHANA. 

(Section on Anatomy). 



CHAl TER 1. 
The Science of Being in General -.—The Twenty -four Tattwas or 

first Principles. — ThePurusha or the Primordial Being or the Self-conscious 
Reality.— The Prakriti or the External Nature personified or the non* 
conscious Eternity — Traits of Commonalty and Diversity. — Comparison of 
the Philosophy of A'yurveda with that of Samkhya as well as with the 
other branches of Philosophy. — Prakriti and Purusha how understood in 
the A'yurveda — Different kinds of Manas (mind). — The five Primary 
Elements of Creation — Their specific function— Their mutual co-operation 
in creation. ... ... ... ... ... 113 — 121. 



CHAPTER II. 

Purification of Semen and Cataminal fluid etc. :— Derange- 
ment of Semen.— Specific treatment. — Derangement of Cataminal fluid.— 
Specific treatment. — Traits of pure and healthy Semen and Cataminal fluid, 
— Menorrhagia. — Amenorrhoea. — Their treatment. — Regimen to be ob- 
served during Menses. — Conduct of husband during the period. — Prohibited 
period. —Conception — Subsequent Conduct. — Causes of different Colours 
in; the child. — About twins — Causes of the child being of Defective Organ 
—Fecundation without sexual intercourse— Causes of Deformity in the child 
— State of the Foetus — Its activity while in the womb. ... 122—133, 



CHAPTER III. 

Pregnancy, etc :— Combination of Self with the Impregnated 
Matter. —Factors which determine Sex. — Period and Signs of Menstruation. 
—Signs of Pregnancy. — Prohibited conducts during Gestation. — Develop- 



VI 

ment of the Foetus. — Longings and its effects during pregnancy.— Develop- 
ment of the Foetus from the Sixth to the Eighth month. — Time of Delivery. 
— Different opinions on th3 formation of the Foetal body. — The solution — 
Factors respectively supplied by the Paternal and Maternal Elements, etc.— • 
External Signs of Male, Female and Twin conception. ... 134—143. 



CHAPTER IV. 
The development of Factors in the womb as well as the 

Factors which contribute to the growths of its different bodily organs and 
principles :— Different folds of skin over the foetus. — The definition of 
Kalas and their varieties. — Seat of the semen. — Why and how semen is 
discharged. — Placenta. — Formation of different limbs and organs of the 
Foetal body. — Sleep and its effect. — Heart and its action. — Effects of day- 
sleep. — Somnolence. — Effect of Sleep on an Enciente woman —Gnawing. 
—The temperaments. — Symptoms of Vataja, Pittaja and Kafaja tempera- 
ments - Symptoms of Dvandvaja and Sannnipatika temperaments. — Sattvika, 
Rajasika and Tamasika features. ... ... ... 144 — 158. 



CHAPTER V. 
The Anatomy of the Human body :— Definition of foetus.— 

Enumeration of the dfferent Limbs and Membeis of body. — Their Numbers— 
The Cavities or Viscera. — Channels. — Kandara. — ^Jala or Plexuses. — Kurcha 
or Cluster. — Sevani or Sutures. — Asthi-Sanghdta. — Simanta. — Bones of 
the four Extremeties. — Bones of the Trunk. — Bones above the Cavicles — 
Different kinds of Bones and theif situation — Sandhi or Joints. — 
Joints of the four Extremities, — Sandhis of the Koshtha and Clavicles. — 
Their forms, distinctions and locations, — The Snayu or Ligaments. — 
Their Number and Situations. — Muscles. — Muscles in the extremities in 
the Koshtha — Of the Head and Neck. — Extra Muscles in Women. — The 
Vaginal Canal — The Uterus — The Womb. — Superiority of Surgery — 
Preparations of dead body — Mode of dissection. ... .. 156 — 172. 



CHAPTER VI. 

The Marmas or Vital parts of the body:— Classifications of 

Marmas— Their different Numbers. — Their Locations. — Their Names and 
Distributions. — The different Heads of Marmas. — Qualitative Classes. — 
Different opinions on Marmas. — Marmas of the Extremities. — Marmas of 
the Thorax, etc. — Marmas in ihe Back. — Marmas in the Clavicular region. 
v—Jheir specific Symptoms when injured. ... ... 173 — i^d. 



Vll 



CHAPTER VII. 
The Description and Classification of Sirsi or the Vascular 

System: — Their Numbers and action. — Names and Classification of the 
principal Siras. — Their specific Locations. — The Pitta, Kapha, Vayu and 
Rakta-carrying S:r4s.— Specific Colours of Sir^s. — The specific Sirds not to 
be punctured. — Siras of the four Extremeties, Trunk and the region above 
the Clavicles and their roots. ... ... ... 191 — 197. 



CHAPTER VIII. 

The method of Venesection : — Persons unfit for Venesection :— 
Preliminary Rules. — The Jantra-Vidhi or how the patient should be placed 
in cas3s of Venesection. — Venesection in the Extremeties. — Venesection on 
the diff'erent parts of the body. — Proper and Defective Venesection — Classi- 
fication and definition of Defective Venesection. ... ... 198 — 208. 



CHAPTER IX. 
The Description of the Arteries, Nerves and Ducts :— Region 

and Number of Dhamanis. — Functions of the up-coursing Dhamanis. — 
Functions of the down-coursing Dhamanis. - Functions of the lateral cours- 
ing Dhamanis. — The Situation of the S rotas and the specific Symptoms 
when pierce 1 at the roots. ... ... ... 209 — 215. 



CHAPTER X. 
Nursing and Manigement, etc- of Pregnant Women from the 

day of conception till parturition :-- General rules. — Especial Regimen 
during the period of Gestation. — Sign of imminent Parturition — Effects of 
premature Urging — Preliminary Measures. --Post-parturient Measures.— 
Natal Rites.— Diet for Children. — Treatment of the Mother— Makkalla pain 
and its treatment. — Management of the Child. — Lactation. — Selection of 
Wet-nurses. — Examination, etc. of Breast-milk. — Treatment of Wet-nurses. 
— Infantile Diseases and their Diagonosis — Treatment of Infants. — I ifant- 
ile Elixirs. — Nursing of child. — Symptoms when malignant stars, etc. 
strike the child.— "Eductation and Marriage. — Defective Pregnancy — Its 
Symptoms and Medical treatment. — Miscarriage — Its treatment. — Manage- 
riient of Pregnancy and special Recipe for Pregnant Women according to 
c months of Gestation. ... ... ... .. 216 — 238. 

£nd of the contents of l^airira Stha^na. 



Vin 



CHIKITSITA STHANA. 

(Section on THERArEUTics). 



CHAPTER I. 

The two kinds of inflamed Ulcers:— The Causes, Symptoms and 
Classification of Ulcers. — Idiopathic and Traumatic ulcers. —General and 
specific Symptoms. —Symptoms of different Dosha-origined ulcers. — Symp- 
toms of Blood-origined ulcers. — Symptoms of Suddha Vrana. — Therapeu- 
tics. — The sixty different Factors of medical treatment of ulcers. — Upadrava 
or the Supervening Symptoms of ulcers. ... ... 269 — 264. 



CHAPTER n. 
The medicxl treatment of Traumatic Wounds or Sores :— 

Different Shapes and Classifications of Sores. — Their definitions — Their 
specific Symptoms — Their treatment.— Treatment of Cuts or Incised 
Wounds. — Treatment of Excised Wounds. — Treatment . of Viscera when 
perforated.— Subsequent treatment. — Treatment of Diabetic Ulcers. — 
Treatment of Ulcers due to Kushtha or malignant Ulcers. ... 265 — 278. 



CHAPTER HI. 
The medical treatment of Fractures and Dislocations :— 

Symptoms of incurable fractures. — Bandage. — Diet.— Defective Bandaging 
—Washing. — Prrgnosis. — Treatment of fractures in particular lir.\bs. — 
Gandha-Taila. — Suppuration of fractured Bones — Symptoms of Complete 
union of fractured Joints. ... ... ... 279 — 288. 



CHAPTER IV. 
The medical treatment of Vatta-Vystdhi or Nervous disorders : 

-!— Nervous affection of the A'mas'aya — Nervous affections of the Pakvas'ayg. 
— S'alvana-upanaha. — General Measures beneficial to Vata-Vyadhi. — The 
Tilvaka-Ghrita. — The Anu-Taila. — The S'ata-paka and Sahasra-paka Taila. 
—The Patra-lavana.— The Kanda or Sneha-lavana. — The Kalyanaka- 
lavana. ... ■•■ <•• ••■ ■■• 289—296. 



IX 



CHAPTER V. 
The medical treatment of Maha^-Vata-Vysidhi :— Causes of 

Vata-Rakta. — Its definition — Premonitory symptoms — Specific features of 
Vata-Rakta — Prognosis. — Preliminary remedial measures. — Plasters etc. — 
Treatment of Vata-Rakta with a preponderance of different Doshas. — The 
five Pradehas— Guda-IIaritaki and Pippali-Vardhamana Yogas. — Diet. — 
Regimen of conduct. — The Medical Treatment of Apatanaka. — Traivrita 
Ghrita. — Treatment of Pakshaghata. — Treatment of Manya-stambha. — 
Treatment of Apatantraka. — Treatment of Ardita. — Kshira-Taila. — 
Tympanites etc. — Hingvadi-vati. — Symptoms and Treatment of Uru- 
stambha. — Therapeutic properties of Guggulu. ... ... 297 — 315. 



CHAPTER VI. 
The medical treatment of Ars'as (Haemorrhoids) :— General 

remedial measures. — Application of Kshara (Alkali). — Symptoms of 
satisfactory, excessive and defective Cauterisation.— Diet — Rectal Speculum. 
— Plasters. — Treatment of Internal piles. — Dantyarishta. — Abhayarishta. — 
Bhallataka-yoga. — Other forms of Bhallataka-yoga. — Regimen of diet and 
conduct. ... ... ... ... ... 316-328, 



CHAPTER VII. 
The medical treatment of Asmari (Urinary Calculus, etc) :— 

Different modes of treatment in As'mari. — Treatment of Vataja, Pittaja 
and Kaphaja As'mari. —Alkaline treatments.— Modes of Surgical operations. 
— Prognosis. — Lithotomic operations. — Post-surgical measures. — Surgical 
treatment in Seminal Concretions. — Diet. — Parts to be guarded in Litho- 
tomic operations, ... ... ... ... 329-337, 



CHAPTER VIH. 
The medical treatment of Bhagandara (Fistula-in-ano, etc) :— 

Classification. — General treatment. — Specific measures. — Different Forms 
and Names of incision. — Treatment of Ushtra-griva. — Treatment of 
Parisravi. —Bhagandara in infants — Treatment. — Treatment of traumatic 
type. —Treatment of Tri-doshaja type. — Syandana Taila. — Description of 
instrument. — Regimen of diet. ... ... ... 338-345. 



CHAPTER IX. 
The medical treatment of Kushtha (Cutaneous Affections in 

general): — Pathology. — Conduct of diet and regimen. — Regulation of 
diet and conduct. — Preliminary treatment. — Treatment of Doshaja types. — 
Maha-tikta Ghrita. — Tikta-Sarpih. — Medicinal plasters. — Alkaline treat- 
ment. — Treatment of S'vitra. — Nila-Ghrita. — Maha-nila Ghrita. — Treatment 
by Bleeding, Emetics and Purgatives. — Vajraka Taila. — Maha-Vajraka 
Taila. — Treatment by Khadira. — Diet. ... ... ... 346-361. 



CHAPTER X. 
The medical treatment of Mahat-Kushtha (Major Cutaneous 

Affections).— Mantha-Kal pas. — Diet. — Medicated Arishtas, Asavas, Suras 
(Wine) and Powders. — Medicinal Ayas-kriti. — Aushadha Ayas-kriti. 
— Mahaushadha Ayas-kriti. — Khadira preparations. ...Khadira-Sara pre- 
parations. ... ... ... »« ... 362-371. 



CHAPTER XI. 
The medical treatment of Prameha (Diseases of the Urinary 

tracts): — Two-fold Classifications, Causes and Symptoms.— Forbidden 
articles of food and drink. ^Articles of diet. — Preliminary treatment.— The 
five medicinal remedies. — Specific treatment of Kaphaja Meha — Specific 
treatment of Pittaja Meha. — Specific treatment of Vataja Meha. —Palli- 
ative measures — Medicinal Arishtas, Asavas, Yavagus, etc. — Mode of treat- 
ing a poor Prameha-patient. .. . ... ... ... 372-378, 



CHAPTER XII. 
The medical treatment of Prameha-Pidaksi (the Abscesses or 

Eruptions which mark the sequel of a case of Prameha) :— Curable cases of 
Prameha- Pidaka. — Treatment. —Dhanvantara-Ghrita.-— Fomentations for- 
bidden in cases of Madhu-meha. — S'ala-saradi Avaleha. — Navaya.sa Churna. 
— Loharishta. — Traits of cure. ... ... ... 379-385, 



CHAPTER XIII. 

The medical treatment of Madhu-meha :~S'ila-jatu— Its origin, 
properties and use. ^-The Makshika-Kalpa.— The Tuvaraka-Kalpa. 286-391. 



i 



CHAPTER XIV. 
The medical treatment of XJdara (Dropsy with an abnormal 

condition of the Abdomen) : — Symptoms of curable and incurable types. — 
Diet of articles forbidden. — Treatment of Vataja, Pittaja and Kaphaja 
types. — Treatment of Dushyodara. — Genera] treatment of Udara. — Haritaki 
Ghrita. — Maha-vriksha Ghrita. — Chavy a Ghrita. — Anaha-Vartis. —Treat- 
ment of Plihodara.— Shat-palaka Ghrita. —Treatment by Venesection. — 
Treatment of Baddha-Gudodara.— Treatment of Parisravi Udara.— Treat- 
ment of Udakodara. —Treatment by tapping, — Diet. .., 392-403. 



CHAPTER XV. 
The medical treatment of Mudha-Garbha (Difficult and mal- 

presentation of the Foetus and Difficult Labour) : — Varieties of Mudha- 
Garbha.— Incantations.— Postures of the Foetus. — Operations involving 
destruction of the Foetus. — Craniotomy. — After-measures. — Diet and regi- 
men of conduct. —The Bala Taila. — The Bala-Kalpa. ... 404-411. 



CHAPTER XVI. 
The medical treatment of Vidradhi (Abscesses) and Tumours:— 

Classifications. — Treatment of Vdtaja, Pittaja and Kaphaja Vidradhi. — 
Karanjadya Ghrita. — Treatment of traumatic and blood-origined types. — 
Treatment of internal Vidradhi. — Treatment of Vidradhi. — Treatment of 
Majja-jata Vidradhi. ... ... ... ... 412-417. 



CHAPTER XVII. 
The medical treatment of Erysipelas etc., Sinus and Diseases 

of the Mammary Glands *. — Classifications of curable and incurable 
types of Visarpa (Erysipelas)— Treatment of Vataja and Pittaja Visarpa. — 
Gauryadi Ghrita. — Treatment of Kaphaja Visarpa. — Treatment of NaCdi- 
Vrana (Sinus). — Treatment of Vataja, Pittaja, Kaphaja and S'alyaja N^di 
(Sinus). — Alkaline treatment— Treatment by Plug-stick — Bhallatakadya 
Taila— Treatment of Stana-Roga—Purification of breast-milk— Surgical 
treatment of Stana-Roga. ... ... ... ... 418-426. 



CHAPTER XVIII. 

The medical treatment of Granthi (Glandular Swellings), 
Apachi (Scarvi), Arvuda (Tumour) and Gala-ganda (Goitre) :— General 



Xll 

treatment of GrantM — Treatment of Vataja, Pittaja, Kaphaja and Medoja 
Granthi. — Medical treatment of ApacM- — Surgical treatment of Apachi. — 
Arvuda — Treatment of Vataja, Pittaja, Kaphaja and Medoja types of 
Arvuda (Tumour), — Gala-ganda — Treatment of Vataja, Kaphaja and 
Medoja types of Gala-ganda (Goitre). ... ... ... 427-438. 



CHAPTER XIX. 

Ihe medical treatment of Vriddhi (Hernia, Plydrocele, Scrotal 
Tumour, etc.), Upadamsa (Diseases of the Genital Organ) and S'lipada 
(Elephantiasis) -.—Treatment of Vataja, Pittaja, Raktaja, Kaphaja, 
Medoja and Mutraja Vriddhi- — Treatment of Antra-Vriddhi. — Treat- 
ment of Upadams'a — General treatment— Treatment of Vataja, Pittaja, 
Kaphaja, Tridoshaja and Raktaja types of Upadams'a. — Treatment of 
Slipada — General treatment — Treatment of Vataja, Pittaja and Kaphaja 
types of S'lipada — Alkaline remedies. ... ... ... 439 — 449. 



CHAPTER XX 

The medical treatment of Kshudra-Roga (Minor Ailments) :— 

Treatment of Aja-gallika and Yava-prakhya. — Treatment of Vivrita, etc. — 
Treatment of S'arkararvuda, etc. — Treatment of Pada-dari, etc. — Treat- 
ment of Alasa and Kadara. — Treatment of Baldness and Alopecia, etc. — 
Treatment of Darunaka, etc. — Treatment of Jatu-mani, etc — Treatment of 
Yuvana-pidaka — Treatment of the Retroflexion of the Prepuce. — Treatment 
of the Constriction or Stricture of the Urethra — Its surgical treatment. — 
Treatment of the Stricture of the Anus, etc. — Treatment of Valmika, Ahi- 
putana and the Prolapsus of the Anus. ... ... 450-458. 



CHAPTER XXI. 
The medical treatment of the Sores on the Penis produced 

by the ^Uka -.—The specific treatment of the different types of S'uka- 
dosha — General treatment. — Prognosis. ... ... ... 459-461. 



CHAPTER XXII. 

The medical treatment of the Affections of the Mouth :— 

Treatment of Vataja, Pittaja, Kaphaja and Medoja types of Oshtha- 



Xlll 

kopa — Treatment of the diseases of the Danta-mula. — Treatment of 
Danta-Veshta etc. — Paridara — S'aushira — Upakus'a — Danta-Vaidarbha — 
Adhimamsa. — Treatment of Danta-nadi. — Treatment of the diseases of the 
different types of Tooth. proper. — Treatment of Tongue-diseaseS — 
Treatment of Valaja, Pittnja and Kaphaja types of tongue-diseases — 
Treatment of the different type;: of Tatiu-gata diseases — Treatment of 
Throat-diseases. — Treatment of Vataja, Pittaja, Kaphaja and Raktaja 
types of Rohini. — Treatment of the different types of the Sarva-sara 
Mukha-Roga. — Incurable types of Mukha-Rcga. ... ... 462-474. 



CHAPTER XXIII. 

The medical treatment of Sopha (Swellings).— Classifications of 
general S'opha — Its causes. — The specific symptoms of Dosha-origined 
types of S'opha. — Symptom of Vishaja S'opha — Complications — Prognosis. — 
The Special treatment of the different types of S'opha. — General remedies. 
—Diet. ... ... ... ... ... 475-477. 



CHAPTER XXIV. 
The Rules of Hygiene and the Prophilactic Measures :— 

Tooth-brushing — Cases where tooth-brushing is forbidden. — Eye and Mouth- 
washing. — Colly rium. — S'iro'bhyanga. — Combing. — Anointing. — Parisheka. 
— Affusion. — Effusion. — Anointments. — Prohibitions of Anointments, etc. — 
Physical Exercise. — Rubbing and Friction. — Massage. — Bathing. — Prohibi- 
tion of Bathing. — Anulepana. — A'lepa. — Food. — Pravata and ISivata.— 
vSleep — General Rules of Conduct. — Rules for Drinking Water, etc. — Curd 
(Dadhi)— When and How to be taken. — Women unfit to visit. — Evil 
Effects of the foregoing Abuses. «« ... ... 480-502. 



CHAPTER XXV. 
The medical treatment of a Variety of Diseases :— Diseases of 

the Ear-lobes— Classification — Causes and Symptoms — General treatment — 
Specific treatment. — Treatment of Palita. — Treatment of Vyanga, etc. 

503-504. 



XIV 

CHAPTER XXVI. 
The medical treatment for inc ing the Strength and the 

Virile Power of weak persons : — Definition of Vaji-Karana — Means of 
Vaji-karana. — Causes and Symptoms of the six P'orms of Sexual incapacity. 
— Incurable types. — Remedies — Utkarika— Pupalika. — Cakes etc. 510-514. 



CHAPTER XXVII. 
The Recipes and Modes of using Elixirs and Rejuvenators :— 

The Human Organism — Which will make it invulnerable to the inroads of 
any Disease and Decay. — Time of using Rasayana. — Rasayana for Mental 
and Physical maladies. — Vidanga-Rasayana — Vidanga-kalpa. — Kas'marya- 
kalpa. — Bala-kalpa. — Ati-bala, Naga-bala, Vidari and S'atavari-kalpa. — 
Varahi-kalpa — Use of S'ana (-seeds). ... ... ... 515-521. 



CHAPTER XXVIII. 
The Elixirs and Remedial Agents which tend to improve the 

Memory and invigorate the Mental Faculties as well as to increase the 
Duration of Human Life : — S'vetavalguja -Rasayana — Krishnavalguja- 
Rasayana — Manduka-parni-Rasayana — Brahmi-Rasayana — Brahmi-Ghrita 
— Vacha-Rasayana — S'ata-paka-Vacha-Ghrita. — Measures for prolonging 
life. — Uses of Gold. ... ... ... ... 522-523. 



CHAPTER XXIX. 

The Restorative and the Constructive Agents which arrest 

innate morbific tendencies and decays : — Classifications of Soma. — Mode of 
using the Soma. — Regimen of Diet and Conduct after taking Soma. — Its 
Therapeutic effects. — Distinctive, features of the Soma-plants — Their des- 
criptions — Their Habitats. ... ... ... ... 530-538. 



CHAPTPR XXX. 
The Tonic Remedies which remove Mental and Physical 

Distress : — Persons unfit for the use of Rasayna. — Names of the healing 
drugs. — The Mode of their use. — Regimen of Diet and Conduct — Dosage — 
Therapeutic effects, — Differentiating traits. — Mode of Culling the above 
drugs.— Their Habitats. — The common Habitat of all the Oshadhis. 

539-545' 



XV 



CHAPTER XXXI. 

The medicinal uses of Sneha, etc, :— Classifications of Sneha— 
Description of Sneha — The specific uses. — Measures of drugs. — The 
Kashaya-paka-Kalpa. — The Sncha-p^ka-Kalpa. — Alternative methods. — 
Application of Sneha according to specific Dosha and Season. — Degrees of 
Cooking a Sneha— Distinctive traits of the complete cooking of a Sneha. — 
Process of Internal Use of Sneha — The Specific Uses of Clarified butter — 
The Dosage. — Evil Effects of over-dosage — Sadyah-Sneha. — Forbidden cases 
of Sneha-pana.— -Good Eff'ects of Sneha-pana. ... ... 546-557. 



CHAPTER XXXn. 
The medical treatment by measures of Sveda (Fomentations, 

Diaphoretic measures etc.): — Classifications of Sveda. — Its Specific Appli- 
cations. — Effects of Sveda. — Prohibited cases of Sveda. — Symptoms of per- 
fect and imperfect Sveda. — Measures to be followed after Sveda. 558-564. 



CHAPTER XXXni. 

The Distresses which prove amenable to the use of Purga- 
tives and Emetics : — Importance of Purgatives and Emetics. — Mode of 
application of Emetics. — Symptoms of excessive, satisfactory and deficient 
Emetics. — Effects of satisfactory Emetics. — Cases where Emesis is forbid- 
den. — Cases where Emesis is recommended. — Mode of administering 
Purgatives. — Classifications of Koshtha. —Diet. — Benefits of proper Purga- 
tion. — Persons who should not be purged. — Persons who should be purged. 
— Necessity of applying Sneha before Ithe administration of Purgative or 
Emetic. ... ... ... ... ... 565-589- 



CHAPTER XXXIV. 

The treatment of the Disorders resulting from an Injudici- 
ous Use of Emetics or Purgatives :— Their Classes.— Cau.ses and treat- 
ment. — Evils of an Unpurged Residue of a Purgative or Emetic. — Evils of a 
Digested Purgative, etc. — Evils of insufficient or excessive expulsion of the 
Doshas. — Flatulent Colic. — Partial -and Deficient Medication (Ayoga). — 
Over-drugging with purgatives, etc. (Ati-yoga). — Haemorrhage due to 
excessive Vomiting or excessive Purging (Jivadana). — ^Jiva-s'onita, how 
to be known. — Flatulent distention of the Abdomen (Adhmana). — Cutting 



XVI 



pain in the Anus, etc. — Dysenteric stools (Parisrava). — Diarrhoea 
(Pravahika). — Overwhahiiing the heart. — Retention (Vibandha) of flatus, 
stool and urine. ... ... ... ... 577 — 589. 



CHAPTER XXXV. 

The Dimensions and Classifications of a Netra and a Vasti 
with their therapentic applications -.—The importance of Vasti- 

Karma. — The application of Vasti in different diseases. — Dimensions of the 
Pipe. — Materials of the Pipe. — Construction of the Vasti. — Classifications of 
the Vasti. — Nomenclature of the Vasti. — Application of Niruha-Vasti and 
Asthapana-Vasti.— Their therapeutic Effects — The different Defects of a 
Vasti. ... ... ... ... ... 590—598 



CHAPTER XXXVI. 

The medical treatment of the mishaps which are consequent 
on the Injudicious Application of the Pipe and the Vasti :— 

Remedies for the injudicious application of the Pipe. — Disorders resulting 
from a defective Vasti (bladder) and its contents. — Disorders resulting 
from the defective Position of the Patient. — Remedies for the Complications 
of the defective position of Niraha-Vasti and Sneha- Vasti. — Intervals for 
the application of Purgative, Emetic, Asthapana-Vasti and Anuvasana- 
Vasti. ... ... ... ... ... 599 — 607. 



CHAPTER XXXVII. 
The treatment with Anuvatsana-Vasti and Uttara-Vasti:— The 

Process of Anuvasana-Vasti — The process of preparing several medicated 
Oils and Snehas. — Proper time for the application of Sneha-Vasti. — The 
mode of applying a Sneha-Vasti. — Symptoms of insufficient, excessive, and 
satisfactory application of Anuvasana-Vasti. — Diet after the application of 
a Vasti. — The Successive Actions of a Vasti. — Distresses from Injudicious 
Application of Sneha-Vasti. — Specific Symptoms — Their remedies. — 
Uttara-Vastis — Dimensions of the Pipe of the Vasti for a Male and for 
a Female patient. — Mode of application. — Vaginal Uttara-Vasti. — Diseases 
amenable to Uttara-Vasti. ... ... ... ... 608 — 626, 



XVll 



CHAPTER XXXVIII. 
The mode of applying, as well as the treatment with a 

Nirudha-Vasti : — The mode of Preparing a Vasti. — The mode of Apply- 
ing a Vasti. — Symptoms of a satisfactory application of a Vasti. — Subsequent 
treatment and Diet — Drugs to b^ used in a Niruha-Vasti. — The Formula of 
a Niruha-Vasti. — The process of preparation. — The Dvadasa-Prasriti. — 
Classifications of Vastis according to the range of their therapeutic appli- 
cations. —Corrective Vastis. — Lekhana- Vasti. — Vaji-Karana- Vasti. — Vrim- 
hana-Vasti. — Pichchhila- Vasti. — Grdhi-Vasti. — Sneha-Vasti. — Utkles'ana- 
Vasti. — Dosha-hara-Vasti. — Soothing Vasti. — Yukta-ratha-Vasti. — Siddha- 
Vasti. — Must^dika-Vasti. — Variations in the composition of Vastis in cases 
of persons of different Temperaments. — Nomenclature of different Vastis 
and .their Specific Uses. ... ... ... 637 — 646. 



CHAPTER XXXIX. 

The treatment of distressing Symptoms which are manifest- 
ed in a patient : — The quantity of diet to be taken after the exhibition 
of a Niruha-Vasti. — Internal application of Sneha after Blood-letting. — 
Preparations of different diets. — Diet to be taken according to the Dosha 
and to the Strength of the patient. — Regimen of conduct. — Articles of diet. 

647—652. 

CHAPTER XL. 
The treatment which consists in employing the Dhuma 

(Fumes), Nasya (Snuffs) and Kavala (Gargles) ;— Classifications of 
Dhuma— Materials ot different Dhuma- Varti. — Formation of the Pipe used 
in Dhuma-Pana — Mode of inhalation of different Dhumas — Prohibitive cases 
—Time of Dhuma-pana (Smoking) — The therapeutic effects of Dhuma- 
Pana— Mode of Smoking.— Snuffs and Errhines (Nasya)— The Nomen- 
clature of the term "Nasya"— Classifications of Nasya — S'iro-Virechana— Its 
application— Dosage of Sneha-Nasya— Effects of proper, excessive and defi- 
cient application of a Sneha-Nasya — Avapida-Nasya — Forbidden cases. — 
Prati-marsha Nasya when to be used- Its effects. — Specific use of Sneha- 
Nasya.— Kavala-graha (Gargles)— Classification— Mode of application— 
Their uses— Kavala and Gandusha distinguished — How long Kavala 
should be retained — Symptoms of satisfactory, deficient and excessive 
Gargling. — Prati-sarana — Its classification and effects. ... 653 — 671. 

End of the Contents of the Chikitsita Sthatna. 



KALPASTHANA. 

(Section on Toxicology). 

CHAPTER I. 
The mode of Preserving Food and Drink from the effects of 

Poison : — The necessary qualifications of a Superintendent of the Royal 
Kitchen — The necessary features of a Royal Kitchen. — Characteristic features 
of a Poisoner. — Indications of poisoned food and drink, etc. — General 
treatment. — The mode of preparing Soup, etc. ... ... 673 — 684. 



CHAPTER ir. 

The Indications (Effects, Nature and Operations) of Sthavara 
Poisons : — Sthavara Poison — Its source. — Names of the different Vegetable 
and Mineral poisons. — Effects of poison on the Human organism. — Effects 
of Bulb-poisons — Specific properties and actions of Bulb-poisons — Definition 
of Dushi-visha — Symptoms of weak and slow poisoning — Derivative 
meaning of Dushi-visha — Symptoms of the different stages of Sthavara 
Poisoning — The medical treatment. — Koshatakyadi-Yavagu — Ajeya-Ghrila 
— Vishari Agada. — Treatment of the supervening Symptoms of Poisoning. — 
Prognosis. ... ... ... ... ... 685 — 694. 



CHAPTER ni. . 
The Subject of (the nature, virtue, etc. of) Animal Foisons :— 

Different locations— Characteristic features and purifications oi poisoned 
Water. — Poisons in the Atmosphere and its purification. — Mythological 
origin of Poison. — Properties of Poison — Nature and Location of Snake- 
poison— General treatment of poisoning — Symptoms of taking poison 
internally. — Fatal bites. — Prognosis. ... ... ... 695 — 702. 



CHAPTER IV. 
The Specific Features of the Poison of a Snake-bite :— Clasifica- 

tions of Snakes — Classifications of Snake-bites — Their specific Symptoms — 
Characteristic features of the different species of Snakes. — Features of the 
different Castes amongst Snakes. — Particular Habits of the different kinds of 
Snakes. — Names of the different species of Darvi-kara Snakes — Names of 



XIX 



the different species of Mandali Snakes— Names of the different species of 
Rajim^n Snakes — Names of the different species of Nirvisha Snakes — Names 
and Origin of the different species of Vaikaranja Snakes — Sub-families of 
the Vaikaranja Snakes. — Characteristic features of Male and Female Snakes — 
Features of Iheir bites — General and specific symptoms of a bite by a Darvi- 
kara Snake— Specific symptoms of a bite by a Mandali Snake— Specific 
symptoms of a bite by a Rdjimdn Snake — Specific symptoms of bites by 
Snakes of different Sexes and Ages, etc. — Symptoms of the different stages 
of poisoning from the bites of a Darvi-kara Snake — Different stages of 
poisoning from the bite of a Mandali Snake — Different stages of poisoning 
from the bites of a Rajiman Snake.— The Vegdtitara (or the intervening) 
Stages. — Different Stages of poisoning in cases of Lower Animals. — 
Different stages of poisoning in cases of Birds. ... ... 703 — 714. 



CHAPTER V. 
The medical treatment of Snake-bites :— General treatment 

of Snake-bites. — Mantras (Incantations) — Blood-letting in Snake-bites — 
Specific treatement of the bite by a Hooded (Darvi-kara) Snake, a Mandail 
Snake and a Rajiman Snake. — Centra-indication to blood-letting in cases of 
Snake-bites. — Dosage of Collyrium, etc., to be resorted to in cases of 
different Beasts and Birds.— General dosage of medicines in cases of Snake- 
bites — Specific treatment of poisoning according to the Physical Sympfoms 
— Specific treatment of the different Supervening Symptoms. — Remedy for 
the aggravated Doshas due to Poison — Medical treatment of persons made 
unconscious from the effects of a Fall or Suspended Animation. --Symptoms 
of wounds from Poisoned Darts, etc. — Treatment of a Poisoned Wound- 
Recipe of different Agadas— Mahagada — Ajitagada — Tarkshya'gada — Risha- 
bhdgada — Sanjivana Agada— Darvi-kara- Rajila-visha-hara-Agada — Man- 
dali-visha-hara Agada— Vams'a-tvagadi Agada— Pancha-s'irisha Agada— 
Sarva-Kamika Agada— Ekasara Agada. ... ... 71^ 727. 



CHAPTER VI. 

Cases of Rat-poisoning : — Different Varieties of Rats— General 
Symptoms of Rat-poisoning— Specific symptoms and treatment of Rat- 
poisoning— General treatment.— Causes of Rabies— Symptoms of Hydro- 
phobia—Prognosis. —Symptoms of Jala-trasa— Its treatment— Treatment of 
bites by rabid-dogs — Treatment of teeth and nail-scratching. 728 — 736. 



XX 

CHAPTER VII. 

Treatment with the Sounds of a (medicated) Drum, etc., 
possessed of Anti-venomous Virtues : — Ksharagada— Its Uses and 

Tharap^utic Effects — Kaiyinaka-Ghri'.a — Amrita-Ghrita ~ Maha-sugandhi 
Agad-x — Rules of Diet and Conduct. — Symptoms of Elimination of Poison. 

737—741- 



CHAPTER VIII. 
On insects, i.e., the measures, etc. to be adopted in cases of 

Insect-bites, etc- : — The Germination and Classification of Insects — 
Insects of Vataja, Pittaja, Kaphaja and Sannipatika temperaments. — 
Symptoms of their Bites— The Kanabha class of Insects — The Gaudheyaka 
class of Insects — S'ata-padi — Manduka (Frogs) — Pipilika (Ants) — Makshika 
(Stinging Flies) — Mas'akas (Mosquitoes). — Incurable classes — Treatment of 
a bite by strong and acute- poisoned Insects — Recipes of Remedies in 
different cases. — Origin and Classification of Scorpions — Specific traits and 
characteristics of Mild -poisoned Scorpions, Madhya-visha Scorpions and 
Tikshna-visha Scorpions — Treatment of Scorpion-bites.— Spider-bites. — 
Development of Luta-poison — Its Potency — Location. — Characteristics of 
Poison according to its seat in the body of a Spider — Mythological Account 
of the Origin of LutSu. — The different names of Spiders and the general 
Symptoms of their Bodies — Specific Symptoms of Spider-bites and their 
Treatment — General Remedies — Specific symptoms of the Incurable cases of 
Spider-bites — Their treatment. — Surgical Treatment— Treatment of Ulcers 
incidental to the Bites by Insects or Snakes. ... ... 742 — 762. 

End of the Contents of the Kalpa Sthaina. 



I 



THE 

SUSHRUTA SAMHITA 

NIDANA STHANAM. 



CHAPTER I. 

Now wc shall discourse on the Vatavyadhl- 

(diseases of the nervous system) Nidaaam*. 

Metrical text:— Having clasped the feet of 
the holy Dhanvantari, who had arisen out of the 
primordial ocean with the pitcher of ambrosia on his 
head, and who was the foremost of all knowers of truth, 
Sus'hruta interrogated him as follows : — "Tell me,0 thou, 
the foremost of discoursers, all about the different 
locations and functions of the bodily Vayu (nerve force), 
both in its normal and agitated conditions, (as well as 
when it changes its natural seat through a concourse of 
disturbing or aggravating causes). Instruct mc on the 
nature of distempers, which result from its deranged 
condition." 2. 

The holy Dhanvantari, the greatest of all healers, 
having listened to the foregoing words of Sus'hruta, replied 
as follows: — This vital Vayu (nerve force), which courses 
through the body, is self-begotten in its origin, and 

* The term Nidanam, usually translated as Pathology, is meant to 
include factors, which fall within the respective provinces of Pathology, 
/Etiology, Symptomology and Pathognomy as well. For the meaning and 
functions of Vayu see Introduction vol. I. pp. xli. — xlii. 



2 TH£ SUSHRUTA SAMHITA. [Chap. I. 

is regarded as identical with the divine energy of eternal 
life (God), Inasmuch as it is unconditional and absolute 
in its actions and effects, eternal and self-origined, 
and is subtile and all-pervading (like the sky and the 
atoms). It is the primary factor, which determines the 
principle of cause and effect in all forms of created 
things, whether mobile or immobile. It is so called 
(Vdyu) from the fact of its coursing (skr. Va — to move) 
throughout the universe. It determines the growth, 
origin and disintegration of all animated organisms, and 
as such, it receives the homage of all created beings. 
Although invisible in itself, yet its works are patent or 
manifest. It is cold, light, mobile, dry and piercing, and 
follows a transverse course. It is characterised by the 
two attributes (proper-scnsibles or Gunas) of sound and 
touch. It abounds in the fundamental quality of Rajas 
(principle of cohesion and action), is of inconceivable 
prowess, propels all the deranged or obstructing prinicples 
(Doshas) in the organism, (or in other words, is primarily 
concerned with the deranged principles of the body 
which are pathogenic in their actions). It is instantaneous 
in its action, and radiates or courses through the organ- 
ism in constant currents. It has its primary field of 
action in the intestinal tract (Pakvadhana) and the 
rectum (Guda). In Its deranged state, it is the principal 
factor, which, (In combination with the deranged PIttam 
and Kapham), lies at the root of all diseases, and Is 
accordingly termed the king of diseases (Rogarat). 3. 

The action of Vayu in its normal 

State : — Now, hear me describe the symptoms, which 
mark the Vayu, as it courses through the organism. 
The Vdyu, in its normal or undisturbed condition, main- 
tains a state of equilibrium between the different Doshas 
and the root principles of the body (Dhatu) ; it further 



Chap. I.] NIDANA STHANAM. 3 

tends to maintain uniform state in the metabolism of 
the body, (protoplasmic, Agni*) and helps the organs 
of sense-perception in discharging their specific functions. 
The bodily Vayu, like the Pittam in the organism, is 
grouped under five different subheads according to the 
difference in its functions and locations, and is classified 
as the Prana, Udana, Samana, Vyana and Apana.f 
These five classes of Vayu, located in their specific 
regions, contribute towards the integration and main- 
tenance of the body. 4 — 6 

The Prana Vayu :— The Vayu, that courses in 
(governs)the cavity of the mouth, | is called the Prdna, its 
function being to force down the food into the cavity of 
the stomach, and to assist the different vitalising principles 
of the body (such as the internal heat or fire etc.) in dis- 
charging their functions in life, and to contribute to the 
I general sustenance of the body. A deranged condition of 
this particular kind of Vayu (Pnina) is usually followed 
by hic-cough, dyspnoea and other kindred distempers. 7. 

The Udana Vayu : —The most Important of the 
vital Vayus, which courses (sends its vibrations) upward, 
is called the Udana. It produces speech, song, etc. In 
its deranged state it brings on diseases which are speci- 
fically confined to regions lying above the clavicles. 8. 

The Samana Vayu :— The Samana Vayu 
'courses in (governs) the stomach (Amashaya) and in the 

* See Introduction Vol. I. p.p. XLVIII— XLIX Mahamahopadhyaya 
Dvarka Natha Kavlratna interprets this Agni as digestive heat (/athardgni). 

t The Prana Vayu is identical with the energy of the nerve centre 
in the medulla ; the Udana with that of the one which is situated in the 
speech centre. The Samana is same as the energy of the epigastric 
plexus, the Udana is same as the energy of the Motor-Sensory Nerves, and 
the Apana is identical with the force of the Hypogastric plexus, 

X The field of its action includes the regions of the heart, throat, bead 
and the nose. 



"4 THE SUSITRUTA SAMHITA. tChap. 1. 

region of intestines (Pakvdshaya). Its functions consist in 
digesting the chyme brought down into the intestines in 
unison with the digestive ferment (Agni), and especially 
in disintegrating its essence from its refuse or excreted 
matter. A deranged or aggravated condition of the 
Samana Vayu causes dysentery, Gulma, and impaired 
digestion, etc. 9. 

The Vyana Vayu :— The Vayu known as the 
Vyana courses (acts) through the whole organism, and its 
functions consist in sending the lymph chyle, etc. all 
through the body and in helping the out-flow of blood 
(Asrik^ and perspiration. Five kinds of muscular move- 
ments* are ascribed to the action of the Vyana V^yu, 
a deranged condition of which is generally attended 
with diseases which are not confined to any particular 
region, member, or organ of the body, but are found to 
affect the whole organism (such as, fever, etc), ro. 

The Apana Vayu :— The Vayu known as the 
Apana acts in the lower region of the intestines 
(Pakvadhana). Its functions consist in bearing down the 
foetus and the faeces and in evacuating the urine, semen 
and catamenial blood. An enraged condition of this Yiyu 
tends to bring on serious diseases, which are peculiar to 
the urinary bladder and the distal portion of the large 
intestine (Guda). An aggravated condition of both the 
Vyana and Apana Vayus may produce Prameha and 
disorders of the seminal fluid, while a simultaneous 
excitement of the five vital Vayus leads to a sure and 
speedy termination of life. 11-12. 

Now we shall describe the nature of diseases, brought 

about by the localization of the variously aggravated 

Vayus in the different parts of the body. — In the cavity 

* Such as expansion, flexion, lowering down ancj lifting up or lateral 
thrusting of any part of the body. 



Chap. I.] NIDANA STIIANAM. 5 

of the Stomach (Amashaya) the deranged or aggra- 
vated Vayu gives rise to vomiting, vertigo, epileptic fits, 
thirst and pain at the sides (Pars'va Sula) and about 
the region of the heart (Hridgraha). In the intestines 
(Pakvashaya) the enraged or disturbed Vayu gives rise 
to a rumbling in the intestines, a piercing pain about the 
region of the umbilicus, scanty and painful urination 
and stool, or their entire suppression (Andha), and pain 
about the region of the coccyx (Trika). 13 — i 5. Similar- 
ly, incarcerated in the sense-organs, such as the cars, etc. 
it tends to deprive them of their respective faculties. 
In the .skin (lymph chyle) it produces a discolouring of the 
complexion, parchedness and twitching in the skin, and 
causes a complete local anaesthesia, giving rise to a 
tingling, piercing pain in the skin, which spontane- 
ously bursts, or becomes marked with cracks and fissures. 
Similarly, the aggravated Vayu interfering with the 
principle of blood gives rise to ulcers. In the flesh, it 
produces painful nodes and tumours (Granthi), while in 
the principle of fat it brings on almost painless tumours 
(Granthi) unattended with any kind of ulcer. Incar- 
cerated in the veins &c. (Sira) it produces a stiffening or 
painful contraction, or a varicose or neuralgic condition ; 
in a ligament (Sndyu), it produces numbness (anaesthesia), 
palsy, aching pain and convulsive jerks ; in a long joint, 
it tends to deprive it of its contractibility and produces 
a painful inflammatory swelling (about the affected 
part). In the bones it produces a wasting (atrophy) of 
the bones which crack and begin to spontaneously burst, 
attended with the characteristic bone-ache. Again in 
that important principle of life, the marrow, it tends to 
dry it up and produces a sort of pain, extending all over 
the body which knows no respite or abatement. Similarly, 
in the principle of semen it tends to produce a scanty, 



6 THE SUSHRUTA SAMHITA. [Chap. I, 

defective, or excessive emission of that vital fluid, or a 
complete stoppage thereof. i6 — 23. 

The Vayu, thus disturbed and agitated, affects in 
succession the lower and the upper extremities of the 
body, and the head, or extends all over the body and 
deranges all its root-principles (Dhatu). The symptoms, 
which mark such conditions of the body, are numbness 
(paralysis), convulsive contortions of the limbs (Akshepa), 
anaesthesia, and various kinds of pain(Sula),and swelling 
(Sop ha) of the body. The deranged Vdyu, having enter- 
ed the natural seats of the Pittam or Kapham, develops 
symptoms, which are peculiar to either of them, and 
gives rise to numerous diseases. 24 — 25. 

The symptoms, which characterise the union of the 
deranged Vayu with the Pittam (in its particular seat) 
are a burning sensation, heat, thirst, and loss of conscious- 
ness, in addition to the symptoms of the Vataja disease 
so generated in that particular part of the body, while 
a similar unison with the Kapham develops coldness, 
swelling and heaviness (o( the affected part). The 
disturbed or agitated Vayu in unison with the principle 
of blood gives rise to a sort of pricking pain (pins and 
needles in the affected locality), which can not bear the 
least touch, or is marked by complete anaesthesia, and 
symptoms, peculiar to the deranged Pittam, follow 
in its train. 26 — 28. 

Vomiting, and a burning sensation, etc. in the body, 
mark the instance when the Prana Vayu is surcharged 
(Avrita) with the Pittam ; while weakness, lassitude, 
somnolence and a general discolouring of the com- 
plexion ( D. R., — loss of taste) characterise a case 
when it is surcharged with the deranged Kapham A 
burning sensation in the body, loss of consciousness or 
epileptic fits, and a sense of giddiness (vertigo) and 



Chap. I.] NIDANA STllANAM. 7 

physical languor are the indications, which distinguish 
a case of the Udana Vayu being surcharged with the 
Pittam ; while a stoppage or absence of perspiration, 
appearance of goose-flesh on the skin, impaired diges- 
tion, coldness and numbness of the affected part 
characterise a case of the same being surcharged with 
the Kapham. 29—32. 

Copious flow of perspiration, heat with a burning 
sensation in the body, and epileptic fits indicate a case 
when the Samana Vayu has become united with the 
Pittam ; while a copious flow of stool and urine, and 
an excess of mucous secretion (Kapham) from the nose 
(fluent coryza) etc. and horripilation mark a case, where 
it has become saturated with the Kapham. 33 — 34. 

Heat and a burning sensation in the affected part 
and a profuse mcnorrhagia mark a case when the 
Apana Vayu becomes surcharged with the Pittam, where- 
as a sense of heaviness in the lower limbs characterises 
a case when it becomes overcharged with the Kapham. 
35—36. 

[Symptoms such as,] burning and jerking in the 
limbs, and a sense of physical languor become manifest 
in the event of the Vyana Vayu being surcharged with 
the Pittam, while a general heaviness of the limbs, stiff- 
ness or numbness of the bone-joints, and an incapability 
of locomotion indicate the fact of its being surcharged 
with the Kapham. 37—38. 

The Nidanam of Vsita Raktam :— 

An over-indulgence in grief, excessive sexual inter- 
course, inordinate physical exercise, drinking large 
quantities of wine, observance of a regimen of diet and 
conduct in a particular season of the year which is im- 
proper to it, use of articles of food which are not con- 
genial to one's own temperament and an improper or 



^ THE SUSHRUTA SAMHITA. [Chap. I. 

baneful use of such oleaginous substances (as oil, clari- 
fied butter etc.) are the factors, which vitiate in common 
the blood and Pittam of a person. The foregoing 
causes especially tend to vitiate or agitate the Vayu 
and blood in persons of delicate constitutions, or in 
corpulent persons, or in those who observe a form of 
perfect continence. 39. 

The vital Vayu becomes enraged or agitated by exces- 
sive riding on horses, camels or elephants, or through 
the lifting or carrying of great weights, etc., or by an in- 
ordinate indulgence in things which are possessed of the 
specific virtue of enraging or aggravating that vital 
principle. On the other hand, an over-indulgence in 
such articles of food as are heat-making in their potency, 
or a surfeit of edibles largely composed of sharp, acid or 
alkaline substances, as well as a large consumption of 
potherbs etc., or an exposure to heat tends to vitiate 
the blood of the organism, and which, on account of such 
contamination, tends to speedily obstruct the passage of 
the fleet-coursing Vayu. The Vayu, thus impeded in its 
course, Ibecomes more and more agitated each moment, 
and is prone to speedily agitate the blood in a similar 
way. The antecedence of the term "Vata" or "Va}^u" 
in the nomenclature of the disease (Vata-Rakta) is owing 
to the precedence accorded to the action of the deranged 
Vayu in bringing about the malady, although it effects 
this In concert with the vitiated blood of the 
organism. 40. 

Similarly, the disease brought about by the agitated 
Pittam, in conjunction with the vitiated or agitated blood, 
is called the Pitta- Raktam, while the one incidental 
to the combination of the deranged Kapham with 
the vitiated blood is called Kapha-E/aktam. In a case 
of Vata-Raktam, the legs, or the lower extremities can 



Chap. I.] NIDANA STHANAM. 9 

not bear the least touch (Hyperaesthesia) and a sort of 
pricking, piercing pain (pins and needles) is experienced 
in those regions. The legs become withered or 
atrophied and lose all sensibility to touch. In a case 
of Pitta Rakt am, the legs become extremely red, hot, 
soft and swollen, characterised by a sort of indescribable 
burning sensation. In a case of Kapha-Raktam, the 
legs become swollen and numbed. The swelling assumes 
a whitish hue and feels cold to the touch, and is 
accompanied by excessive itching. In the Sannipatika 
or Tridoshaja form of Dushta-Rakfcam, the legs exhibit 
symptoms, which are respectively peculiar to all the 
three preceding types. 41 — 43. 

Premonitory Symptoms : —In the incuba- 
tive stage of the disease the legs perspire and become 
cold and flabby, or (on the contrary\ the local perspira- 
tion is stopped and the legs become hot and hard. More- 
over, a pricking pain is experienced in the affected parts 
which are marked by complete anaesthesia, heaviness, or 
heat, and discolouring of the skin. The disease creeps 
in either from the lower extremities, or in some cases, 
first affects the upper ones and gradually extends all 
over the body like an enraged rat-poison. 

Prognosis : — The form of the disease in which the 
skin of the part lying between the instep and the knee- 
joint becomes abraded or spontaneously bursts open, 
exuding pus and blood, attended with loss of strength 
(Prana) and flesh, curvature of the fingers, and eruptions 
of nodules, should be regarded as incurable ; while a 
case of one year's standing admits only of palliative 
measures. 44. 

The enraged or agitated Vayu, while coursing swiftly 
through the Dhamanis (nerve.s) of the body, shakes it in 
quick succession, and a disease, (exhibiting such 



10 THE SUSHRUTA SAMHITA. [Chap. I. 

symptoms as shaking or convulsive jerks), is originated 
which is called Akshepaka* (spasms, convulsions). The 
form of the disease, in which the patient falls to the 
ground, at intervals, is called ApataLnaka (Epilepsy 
without convulsions). The aggravated or agitated Vayu, 
charged with an abnormal quantity of Kapham, some- 
times affects and stuffs the entire nervous system, and 
gives rise to a form of disease, which is called Dandai- 
pataiaakaTnt (Epilepsy with convulsions), inasmuch as it 
deprives the body of its power of movement and flexibility, 
making it stiff and rigid like a rod (Danda). 45 — 46. 

The disease but rarely yields to medicine and, is 
cured in rare instances only with the greatest difficulty ; 
its characteristic symptom being a paralysis of the jaw- 
bone, which makes deglutition extremely difficult. The 
disease in which the enraged Vayu bends the body like 
a bow is called Dhanushtambha (Tetanus). The disease 
admiits of being divided into two distinct types accord- 
ingly as the body of the patient is curved internally 
(Antaraiyama, lit:— inwardly or forwardly extended, 
emprosthotonos), or externally (Vahirakyatma, lit : — ex- 
tended or bent on the back, resting on his heels and 
occiput — Opisthotonos). When the extremely enraged 
and powerful bodily Vayu (nerve-force), accumulated in 

* The patient suffers from vanishings (idniyale) and loss of con- 
sciousness through the instrumentality of the enraged and aggravated 
Vayu, hence the disease is so named — Gayaddsa. 

t Jejjada holds that the enraged Vayu, in unison with the deranged 
Kapham, gives rise to another kind of convulsions (Akshepaka) which he 
has denominated as Danda-patanakh which, exhibits such symptoms as 
coldness, swelling and heaviness of the body on account of its being 
brought about by a concerted action of the deranged Pittam and Kapham. 
Several authorities aver that there are four distinct types of Akshepakah, 
such as Danda-patanakh, Anlarayamah, Vahirayamah, and Akshepakh 
of traumatic (Abhighataja) origin. 



Chap. I.] NIDANA STHANAM. II 

the regions of the fingers, Insteps, abdomen, chest, heart 
and throat, forcibly draws in the local ligaments (Snayu), 
the body becomes contracted and bent forward, bringing 
about a curvature of the inner trunk. The disease 
in this form is called Antarayatma Dhanushtambha. 
The movements of the eyes become impossible, which 
become fixed in their sockets ; the jaw-bones become 
paralysed, the sides are broken, and the patient ejects 
(at intervals quantities of) slimy mucous (Kapham). 
These are the features which mark the first type 
(Antarayama Dhanushtambha). On the contrary, when 
the same enraged Vayu, centred or lodged In ligaments 
which traverse the posterior side of the body, attracts 
them violently, the body is naturally bent backward. 
The patient experiences a sort of breaking pain at 
the chest, waist and thighs, (which are ultimately 
broken). The disease Is called Vahiratyatma, and should 
be looked upon as beyond the pale of all medicinal 
treatment. 47 — 50. 

Four types of Akshepaka are usually- recognised 
in practice such as, the (i) one incidental to the 
concerted action of the enraged bodily Vayu and 
Kapham (2), the one brought about through the union 
of the enraged Vayu with the deranged Pittam, (3), 
the one due to the single action of the agitated Vayu 
(4) and the one due to any external injuiy or blow 
(Abhighataja).* An attack of Apatdnkah due to excessive 
haemorrhage, or following closely upon an abortion or 
miscarriage at pregnancy (difficult labour), or which is 
Incidental to an external blow or injury (traumatic), 
should be regarded as Incurable. 51 — 52. 

* Brahma Deva designated the four types of the disease, as Apatanakah, 
Samsrishta Akshepakah, simple Akshepakah and the Abhighataja 
(traumatic). 



il;2 THE SUSHRUTA SAMHITA. [Chap. I. 

The disease, in which the extremely agitated Vayu 
affects the nerve chains (Dhamanis) which spread either 
in the left or in the right side of the body, whether in 
the upward, downward, or lateral direction, making them 
lax and vigourless, and in which the joints of the other 
side of the body become useless and inoperative, is called 
Pakshfiighstta (Hemiplegia) by eminent physicians. 
The patient, the whole or half of whose body has 
become (almost) inoperative and lost all sensibility, but 
who retains his consciousness so long as there remains 
the least vestige of vitality in the affected part, suddenly 
falls down and expires. 53 — 54. 

ProgTIOSis:— -A case of Pakshaghata (Hemi- 
plegia), brought about through the single action of the 
enraged or agitated Vayu of the body, can be cured 
only with the greatest care and difficulty. A case of 
the same disease, engendered by the aggravated Vayu 
in conjunction with the deranged Pittam or Kapham, 
proves amenable to medicine (Sadhya). It becomes in- 
curable when caused through the waste of the root prin- 
ciples (Dhatu) of the body. 55. 

Apatantrakah (Convulsions) :— The Vayu, 
aggravated (by its specifically exciting factors and 
principles) and dislodged from its natural seat or recep- 
tacle in the body in consequence thereof, courses upwards 
and finds lodgment in the regions of the head, heart and 
temples. It presses upon those parts and gives rise to 
convulsive movements of hands and legs, or at times 
bends them down. 

Symptoms :— The patient lies with his eyes 
closely shut, or stares with a sort of fixed or vacant 
gaze, the eyes remaining fixed or immovable. The 
patient loses all perception, and groans. Respiration 
becomes difficult, or symptoms of temporary asphyxia 



Chap. I.] NIDANA STHANAM. 1 3 

and unconsciousness set In. Consciousness and a normal 
condition of the organism return with the passage 
of the enraged Vayu from the heart, while on the 
other hand the patient relapses into unconsciousness 
simultaneously with the envelopment of the heart with 
that enraged and Kapha-e^aturated Vayu. This disease 
is called Apatantrakah and is ascribed to the action 
of the enraged Vayu surcharged with the deranged 
Kapham. 56. 

IVIanyastambha:— The local Vayu, agitated 
through such causes as sleep in the day time, reclining 
with the neck on an uneven place or pillow, gazing 
upward for a considerable length of time, or looking 
aside in a contorted way, and enveloped in the deranged 
Kapham, gives rise to the disease known as Manya- 
stambha (wry neck or torticollis). 57. 

Arditam (Facial Paralysis) :~*P regnant women, 
mothers immediately after parturition (Sutika), infants, 
old and enfeebled persons are most prone to fall victims 
to this disease*. It has been also known to result from 
excessive haemorrhage or loss of blood. The local Vayu, 
extremely enraged or aggravated by continuous talking 
in an extremely loud voice, chewing of hard substances, 
loud laughter, yawning, carrying extremely heavy loads, 
and lying down in an uneven position on the ground, 
finds lodgment in the regions of the head, nose, upper lip, 
chin, forehead and the joints (inner cornea) of the eye, 
and produces the disease called Arditam by distorting 
the face. 

Symptoms : —The neck and half of the face 
longitudinally suffer distortion and are bent. The head 
shakes ; the power of articulating speech is lost, and th^. 

* The portion of the text included within asterisks has been reject 
by Jejjadacharyya as spurious. 



14 THE SUSHRUTA SAMHITA. [Chap. I. 

eyes are distorted Into a variety of shapes. The portions 
of the neck and the chin, as well as the teeth on the 
affected side become painful. 

Premonitory Symptoms :— The disease 

generally commences with shivering, horripilation, 
cloudiness of vision, upcoursing of the bodily Vayu and 
anaesthesia, a pricking pain in the affected locality, 
numbness or paralysis of the jaw-bone, or of the cervical 
muscles of the neck. Physicians, conversant with the 
Etiology of diseases, call it Arditam (Facial paralysis). 
Prognosis :— A case of Arditam, appearing in an ex- 
tremely enfeebled or emaciated patient, or exhibiting 
such symptoms as a winkless vision, inarticulate speech 
which hardly seems to come out of the throat, excessive 
palsy of the face, as well as the one of more than three 
years' standing, should be deemed as incurable. 58. 

Gridhras'i (Sciatica): — The disease in which the 
two great nerve-trunks (Kandara), which emanating from 
below the lower extremity of the thigh reach down to 
the bottom of the insteps and toes, and become stuffed or 
pressed with the enraged Vayu, thus depriving the lower 
extremities of their power of locomotion, is called 
Gridhras'i. 59. 

ViS'vachi (Erbe's paralysis or Bracial neuralgia):— 
The disease in which the enraged Vayu affecting the 
nerve-trunks (Kandara) which run to the tips of fingers 
behind the roots of the upper arms, making them 
[capable of movement and depriving them of their 
)wer of flexion or expansion is called Vis'vachi* 60. 

KrOShtukaS'irsha (Synovitis of the knee- 
Ints) : — An extrimely painful swelling in the knee- 
When the aforesaid nerve of a sirgle arm is afTecld the disease is 
:ted to it alone, while it attacks the both when both their nerves are 



Chap. I.] NIDANA STHANAM. 1$ 

joints, which is originated through the concerted action 
of the deranged Vayu and the vitiated blood is called 
Kroshtukas'irsha from the fact of its resembling the 
head of a jackal (Kroshtuka) in shape. 6i, 

Khan ja (Lameness): — The disease proceeds from 
the drawing up of the nerve trunks (Kandara) of a leg 
by the deranged Vayu lying about the region of the 
waist. When both the legs are similarly affected, the 
patient is called a Pangu. He, whose legs tremble before 
starting for a walk and who afterwards manages to go 
on limping is called a Kalaya Khanja one in whom the 
bone-joints become loose. 62 — 6^. 

Vata Kantaka : -The local Vdyu, enraged by 
making a false step on an uneven ground, finds lodg- 
ment in the region of the ankle (Khudaka, instep 
according to others), thus giving rise to a disease 
which is called Vata Kantaka. The burning sensation 
in the soles of the feet caused by the enraged local 
Vayu, in conjunction with the deranged Pittam and 
blood, is called Pada-daha, which is generally seen to 
afflict persons of pedestrian habits. When the legs are 
deprived of all sensibility of touch, and a sort of tingling 
pain is experienced in them it is termed Padaharsha, 
which is due to the deranged action of the Vayu and 
Kapham. The disease in which the enraged local Vayu 
dries up the normal Kapham lying about the shoulder- 
joints is called Ansa-s'hoshaka. The form in which the 
aggravated local Viiyu contracts the nerves of the arms 
is called Avavahuka*. 64—67. 

Vad hiry ay am (deafness) :— The disease occurs 
only when the deranged Vayu, either singly or sur- 

* The Ansa-shosha is due to the single action of the enraged Vayu, 
while Ava-vahuka is due to the concerted action of the deranged Vayu 
and Kapharo, 



1 6 THE SUSHRUTA SAMHITA. [Chap. L 

charged with the Kapham, stuffs the sound-carrymg 
channels (Srota) of the ears. 68. 

Kama S'ulam:— The disease in which the 
deranged Vayu causing a piercing pain in the regions of 
the cheekbones, head, temples and neck, gives rise to a 
sort of aching pain in the tympanum, is called Karna- 
s'ulam (otitis). The local Vayu, deranged and saturated 
with the Kapham stuffing the nerves (Dhamani) which 
conduct of the sound of speech, produces complete (in 
some cases partial) loss of the power of speech — eg. 
Muka (dumbness , Minmina (nasal voice) and Gad-gada 
(indistinct speech). 69 — 70 

A sort of pain, which (rising from the bowels or the 
urinary bladder and ranging downward) gives rise to 
a bursting sensation in the regions of the anus and the 
genitals, is called Tuni, whereas the one, rising upward 
from the preceding parts and extending up to the region 
of the intestines, is called Prati-tuni. A distension 
of the abdomen (Udara), attended with the incarceration 
of flatus (Vayu) and an intense pain and rumbling in its 
inside, is called Adhmsinam (Tympanites). When it first 
affects the stomach fAmasaya) and is unattended with an 
oppressive feeling about the heart and pain at the sides' 
it is called Praty^dhmaiinam. The Vayu saturated with 
the deranged Kapham causes the preceding type of 
distemper. 71—74. 

A knotty stone-like tumour (Granthi) of consider- 
able density, whether fixed or mobile, and appearing 
below the umbilicus, and having an elevated shape which 
is always found to be extended in an upward direction, is 
called a VatabSthilSb, (which) as its name implies, is due 
to the action of the local deranged Vayu. The tumour, 
thus formed, obstructs the emission of flatus and impedes 
the evacuation of faeces. A tumour of similar shape, 



Chap. I.] NIDANA STilANAM. I^ 

appearing laterally or across the region of the abdomen 
(Jathara) and obstructing the passage of stool, urine 
and flatus (Vata) is called a Pratyashthila'. 75 — ^6. 

Thus ends the first Chapter of the Nidana Sthanam in the Subhruta 
Samhita, which treats of the Nidanam of the diseases of the nervous 
system. 



\ 



CHAPTEE 11. 

Now we shall discourse on the Nidanam of 
Ars'aS (Haemorrhoids}, i. 

Haemorrhoids may be divided into six classes viz : — 
(i) Vdtaja (due to the action of the deranged Vayu\ 
(ii) Pittaja (due to the action of deranged Pittam), (iii) 
Kaphaja (due to the action of deranged Kapham), (iv) 
Raktaja (due to the action of the vitiated blood), (v) 
Samiipdtaja (due to the concerted action of the deranged 
Vayu, Pittam and Kapham i and (vi) Sahaja (congenital). 

PathoIOg^y : —The deranged Vayu, Pittam, etc. 
enraged by their specific aggravating causes, or by such 
acts or conduct as partaking of food composed of in- 
compatible substances, eating before the previous meal 
has been digested, inordinate sexual intercourse, sitting on 
the haunches, excessive riding, and the voluntary suppres- 
sion of any natural urging of the body, either severally 
or in combination of two or three Doshas, or vitiating 
the blood of a person, who observes no moderation in 
food and drink &c., become dislodged from their natural 
seats in the body [according to the law of Prasaranam 
(expansion and change of place by a deranged organic 
principle)] and are carried down through the large 
intestine (Pradhana Dhamani) into the descending colon 
and getting lodged therein, give rise to growths of 
polypi or fleshy condylomata, which are known as piles. 
These growths chiefly appear in persons suffering from 
impaired digestion (Agni), and gain in size through 
friction with the wearing apparel, weeds, wood, lumps 
of clay or stone, or by contact with cold water. 3. 

The lower end of the large intestine, which passes 
into the flexure of the rectum and measures four and 



Chap. II J NIDANA STHANAM. I9 

a half fingers in length, is called the Gudam (lit — 
the channel of fecal matter), the interior of which is 
provided with three spiral grooves. Each of these grooves 
or ring-like muscles lie a finger and a half apart, and 
are respectively known as Pravdhini, Visarjani and 
Samvarani, or the grooves of out-flow, defecation and 
closure of the anus (sphincter ani), covering a space of 
four fingers and having laterally an elevation of one 
finger's width. 4. 

Metrical Texts :— These grooves are like the 
involuted indentures of a conch shell, situated one above 
the other, coloured like the palate of an elephant. A 
part of the channel, half a finger's width in length as it 
is usually measured from the outer hairy orifice of the 
rectum, is called the anus (Gudoushtha). 5 — 6. 

The first of the aforesaid grooves or rings lies about 
a finger's width apart from the orifice of the anus. 

Premonitory Symptoms :~A non-relish 

for food, a tardy and difficult digestion of food (brought 
into the stomach), acid eructations, a sense of weakness 
in the thighs, a rumbling sound in the intestines, emacia- 
tion of the body, frequent eructations, swellings around 
the eyes, a croaking sound in the intestines, cutting 
pain in the rectum (Guda), apparent indications of an 
attack of phthisis, jaundice, dysentery, cough, dyspnoea, 
vertigo, somnolence, excessive sleep, weakness of the 
organs (Indriya), are indications which predict the 
advent of this disease, and which become more marked 
with its progress. 7. 

The Vataja Type :— Piles, due to the action 
of the aggravated Vayu, arc non-exuding, rose-coloured, 
and uneven in their surface. They resemble the Kadamba 
flowers in structure and are either tubular or sharp- 
pointed like a needle, sometimes assumino- the shape of 



20 THE SUSHRUTA SAMHITA. [Chap. II. 

the wild Tundikeri flower. The stool of a hsemorrhold 
patient of this type becomes excessively hard, and can 
be evacuated only in a sitting posture, with the greatest 
pain and difficulty. An excruciating pain is experi- 
enced in the regions of the waist, back, sides, 
anus, umbilicus and the genitals. Symptoms peculiar 
to Gulma, Ashthila, enlarged spleen and abdominal 
dropsy add to the distress of the patient, whose skin, 
nails, eyes, teeth, face, urine and stool also assume a 
dark black colour. 8. 

The Pittaja Type :— Piles, brought on 
through the action of the deranged Pittam, are slender, 
blue-topped, shifting in their nature, yellowish in their 
hue, or are coloured like shreds of liver, resembling in 
shape the tongue of the Suka bird. They are thick at 
middle, like barley grains, or resemble the mouth of 
leeches and secrete a sort of slimy exudation. The 
stool is marked with blood, and the patient complains of 
a painful, burning sensation (in the rectum) at the 
time of defecation. Fever, with a burning sensation and 
thirst, and epileptic fits, supervene. The skin, nails, 
eyes, face, teeth, stool, and urine of the patient assume 
• a yellow hue. 9. 

The Kaphaja Type :— Piles, due to the action 
of the deranged Kapham, become white, are sunk 
about their roots, and are hard, round and glossy. They 
assume a greyish hue and resemble the teats of a cow or 
the stones of the Karira, or of a Panasa fruit. These 
piles do not burst, nor do they exude any sort of secretion. 
The patient feels an irresistible tendency to scratch the 
excrescences. The stools become copious in quantity 
and are charged with mucous (Sleshm^), resembling 
the washings of meat. Indigestion, fever with shivering 
(Sita-jvara), and heaviness of the head and oedema 



Chap. II.] NIDANA STHANAM. 21 

with a non-relish for food are the symptoms which be- 
come manifest with the progress of the disease. The 
skin, finger nails, eyes, teeth, face, sLool and urine of the 
patient also assume a white colour. lO. 

The Raktaja Type :- Piles (haemorrhoids), 
having their origin in the vitiated condition of the blood 
resemble the sprouts of the Vata tree in shape and are 
of the colour of red coral, or the seeds (dark red) 
of Gunja berry. They exhibit all the symptoms, 
which are peculiar to the Pittaja type of this disease. 
Pressed hard by the constricted fi-eces in their 
passage through the anus, they suddenly give rise to a 
hcxmorrhage of vitiated (venous) blood, and symptoms 
characteristic of excessive bleeding are found to 
supervene, il. 

The Sannipata Type :- in a case of 

haemorrhoids due to the concerted action of the 
deranged Vayu, Pittam and Kapham, symptoms 
characteristic of each of these types manifest themselves 
in unison. 12. 

The Congenital Type :— Congenital hemor- 
rhoids (Sahaja Arsas) are usually ascribed to defects in 
the semen and ovum of one's parents and should be 
medicinally treated with an eye to the special deranged 
Doshas involved in the case. The polypi (in this type) 
are hardly visible and are rough and yellowish, with their 
faces turned inward. They are extremely painful. A 
person suffering from this type of piles gets thinner and 
thinner every day and eats but very little. Large veins 
(Sird) appear on the surface of the body. The patient 
becomes irritable, the semen decreases in quantity, 
making the procreation of a small number of children 
possible only by him. The voice becomes feeble, the 
digestion is impaired, and disorders affecting the head 



22 THE SUSIIRUTA SAMHITA. [ Chap. II. 

nose, ears and eyes follow. A croaking sound is 
heard in the intestines, attended with a rumbling in the 
abdomen. All relish for food vanishes and the region 
of the heart seems to be smeared with a kind of sticky 
paste (of mucous), etc. 13. 

Auhoritativc verse on the subject :— 

A qualified physician should undertake the medical treat- 
ment of haemorrhoids which occur cither about the 
outer or the middle groove of the rectum, (in as much as 
they prove amenable to medicine). A polypus, appear- 
ing about the innermost ring or groove of the rectum, 
should be treated without holding out any definite hope 
of cure to the patient. 14. 

Ling'ars'aS (Fig warts or condylomatous growths 
about the genitals): — The deranged and aggravated 
Vayu etc., finding lodgment in the genitals, vitiate 
the local iiesh and blood, giving rise to an itching sensa- 
tion in the affected localities. The parts become ulcerat- 
ed (through constant scratching) and the ulcers become 
studded with sprout-like vegetations offlesh(warts),which 
exude a kind of slimy, bloody discharge. These growths, 
or excrescences generally appear on the inner margin, or 
on the surface of the glans penis, in the form of soft, 
slender vegetations of skin, resembling the hairs of a 
small brush (Kurchaka). These vegetations ultimately 
tend to destroy the penis and the reproductive faculty 
of the patient. 

Bhagars'aS :— The deranged Vayu etc. of the 
body, lodged in the vaginal region of a woman, gives rise 
to similar crops of soft polypi in the passage. They 
may crop up isolated at the outset, and (by coalescing) 
may assume the shape of a mushroom, or an umbrella, 
secreting a flow of slimy, foul-smelling blood. 

The deranged Vayu, etc. may further take an 



Cbap. II.] MDANA STHANAM. ^3 

upward course, and finding a lodgment In the ears, nose, 
mouth and eyes may produce similar warts in those 
localities. Warts, which crop up inside the cavities of 
the ears, may bring on earache, dumbness, and afoul dis- 
charge from those organs, while those (cysts) cropping up 
in the eyes will obstruct the movement of the eye-lids, 
giving rise to pain and a local secretion and ultimately 
destroy the eye-sight. Similarly, such growths in the 
nostrils produce catarrh, excessive sneezing, shortness 
of breath, headache, nasal speech and the complaint 
known as Futinasya. Such vegetations cropping up in 
and about the lips, palate or the larynx, tend to make the 
speech confused and indistinct. When appearing in the 
mouth, they impair the faculty of taste, and diseases 
which affect the cavity of the n^outh follow. The ex- 
cited Vyana Vayu, united with the aggravated Kapham, 
produces a kind of hard papillomatous growths on the 
skin (about the anus) which are called the Charmakilas 
(papillomata).* 15. 

Authoritative verses on the subject : 

— These Charmakilas may be attended with a kind of 
pricking pain through an excess of the deranged Vdyu, 
whereas those which have their origin in the deranged 
Kapham (lymphatics) assume a knotty shape and be- 
come of the same colour as the surrounding skin. On 
the other hand, they become dry, black or white, and 
extremely hard through an exuberance of the deranged 
local blood and Fittam. 16. 

The symptoms of polypi, appearing in the neighbour- 
hood of the anus, have been described in full, while the 
general characteristics of those, which are found to 
crop up around the genitals, have been briefly discoursed 

* According to others, Charmakilas may crop up on the skin of any 
part of the b dy. 



^4 THE SUSMRUTA SAMHITA. [Chap. II. 

upon. An intelligent physician should ponder over 
the two groups of symptoms while engaged in treating 
a case of piles. A case of piles exhibiting symptoms 
peculiar to the two deranged Doshas is called the 
Samsargajam. Six distinct types of bio-Doshaja piles 
arc known in practice.* 17. 

Prognosis :— A case of piles due to the con- 
certed action of the three deranged Doshas of the body, 
(with its characteristic symptoms) but partially develop- 
ed, may be temporarily checked (Yapya). Cases, which 
are of more than a year's standing, as well as those in 
which the hciemorrhoids are due to the concerted action 
of the two Doshas (Samsargaja), or are situated in the 
middle groove of the rectum, may be cured but with 
the greatest difficulty. Cases of the Sannipatika or 
congenital (Sahaja) types . should be given up as 
incurable. The Apana Vayu, in a person whose rectum 
is overrun with such polypus growths, tries to pass out 
through the anus, but is driven back upward, being 
obstructed in its passage by the vegetations, and then 
mixes with his Vyana Vayu, thus imparing (the five- 
functioned) fire (Pittam) in his body. 18-19. 

* Such as (i) the one due to the concerted action of the deranged 
Pittam and Kapham, (2) the one incidental to the simultaneous derange- 
ment of the Vayu and the Kapham, (3) the one brought about through the 
disordered condition of the Vayu and blood, (4) the one due to the 
combination of the deranged Pittam and Kapham, (5) the one produced 
by the concerted action of the deranged Pittam and blood, (6) the one 
which results from the combined action of the deranged Kapham 
and blood. 

Thus ends the second Chapter of the Nidanasth^nam in the Sus'ruta 
Samhita which deals with the Nidanam of piles. 



I 



CHAPTER III. 

Now we shall discourse on the Nidanam of As'« 
mari (urinary calculi). I. 

The disease admits of being divided into four several 
types, such as the Vdtaja, the Pittaja, the Kaphaja and 
the Sukraja (Seminal) concretions. An exuberance or 
preponderance of the deranged Kapham should be under- 
stood as the underlying cause of all invasions of this 
disease. 2. 

General aBtioIOgy :— The Kaphah of a man, 
who neglects to cleanse (Samsodhana) the internal 
channels of his organism, or is in the habit of taking 
unwholesome food, enraged and aggravated by its own 
exciting causes, is carried into the urinary bladder. 
Here it becomes saturated with the urine, and gives rise 
to the formation of concretions or gravels in its cavity. 3, 

Premonitory Symptoms:— An aching 

pain in the bladder, with a non-relish for food, difficulty 
in urination, an excruciating pain in the scrotum, penis, 
and the neck of the bladder, febrile symptoms, physical 
lassitude, and a goat-like smell in the urine are the 
symptoms, which indicate the formation of gravel in 
the bladder. 4. 

Metrical Text ;— The deranged Doshas involv- 
ed in a particular case respectively impart their specific 
colour to the urine, and determine the character of the 
accompanying pain. The urine becomes thick, turbid, 
and vitiated with the action of the aggravated Doshas, 
and micturition becomes extremely painful. 5. 

Leading Indications :— A sort of excru- 
ciating pain is experienced either about the umbilicus, 
or in the bladder, or at the median rape of the 

4 



26 THE SUSHRUTA SAMHITA. [Chap. III. 

perineum, or about the penis, during micturition when 
gravel is forming in the bladder. The urine is 
stopped at intervals in its out-flow, or becomes charged 
with blood, or flows out twisted and scattered like 
spray, leaving a sediment of clear, sandy, red or yellow 
particles of stone, which resembles a Gomedha gem in 
colour. Moreover a pain is experienced in the bladder 
at the time of running or jumping or in swimming, or 
while riding on horseback, or after a long journey. 6. 

The ^leshmas'mari:— Stone or gravel, ori- 
ginated through the action of the deranged Kapham, 
saturated with an excessive quantity of that Dosha by 
the constant ingestion of phlegm-generating (Slesh- 
mala) substances, increases in size at the lower orifice of 
the bladder and ultimately obstructs the passage of the 
urine. The pressure and recoil of that incarcerated fluid 
on the walls of the urinary badder gives rise to a kind of 
crushing, bursting, pricking pain in that organ, which 
becomes cold and heavy. A Kapha-origined stone or 
gravel is white and glossy, attains to a large size, to 
that of a hen's egg, and has the colour of the Madhuka 
flower. This type is called S'leshmas'mari. 7. 

The Pitta ja As'mari :— The Kapham 

charged (dried) with the deranged Pittam becomes hard 
(condensed) and large in the aforesaid way, and lying at 
the mouth of the bladder obstructs the passage of the 
urine. The bladder, on account of the flowing back of 
the obstructed urine into its cavity, seems as if it has 
been exposed to the heat of an adjacent fire, boiling 
with the energy of an alkaline solution. A kind of 
sucking, drawing and burning pain is experienced in the 
organ. This type of As'mari is further marked by 
symptoms which characterise Ushna-v^ta (stricture). 
The concretion is found to be of a reddish, yellowish 



Chap. III.] NIDANA STHANAM. 2; 

black colour like the stone of the Bhalldtaka fruit, or it 
is coloured like honey. This type is called Pittaja 
As'mari. 8. 

The Vatas'mari :— The deranged Kapham 
(mucus) inordinately saturated with the bodily Vdyu, 
acquires hardness and gains in dimensions, and these 
lying at the mouth of the bladder obstructs the passage 
of the urine. The incarcerated fluid causes extreme 
pain in the organ. The patient constantly under severe 
pain gnashes his teeth or presses his umbilical region, 
or rubs his penis, or fingers his rectum (Pdyu) and 
loudly screams. A burning sensation is experienced 
in the penis, and urination, belching and defecation 
become difficult and painful.* The concretions in this 
type of As'mari are found to be of a dusky colour, 
rough, uneven in shape, hard, facetted and nodular like 
a Kadamva flower. This type is called Vdtas'mari. 9. 

Infants are more susceptible to an attack of any of 
the three preceding types of As'mari, inasmuch as they 
are fond of day sleep or of food composed of both whole- 
some and unwholesome ingredients, and are in the habit 
of eating before the digestion of a previous meal, or of 
taking heavy, sweet, emollient and demulcent food. In 
children the bladder is of diminished size and poor in 
muscular structure. These facts contribute to the easy 
possibility of the organ being grappled (with a surgical 
instrument) and of the stone being extracted with 
the greatest ease in cases of infantile As'mari. 10. 

The ^UkraS'mari : — Sukras'maris or seminal 
concretions are usually formed in adults owing to the 
germination of semen in their organisms. A sudden or 
abrupt stoppage of a sexual act, or excessive coition 
tends to dislodge the semen from its natural receptacle 

* Stool and urine can be voided only with the greatest straining. 



2^ THE SUSHRUTA SAMHITA. [Chap. III. 

in the body. The fluid thus dislodged, but not emitted, 
finds a wrong passage. The Vayu gathers up the fluid 
(semen), thus led astray, and deposits it (in a round or 
oval shape) at a place lying about the junction of the 
penis and the scrotum and dries up the humidity with 
which it is charged. The matter, thus formed, condensed, 
and hardened, is called the seminal stone (Sukrds'mari), 
which then obstructs the passage of the urine, giving 
rise to pain in the bladder, painful micturition, and 
swellino; of the scrotum. The stone vanishes under 
pressure in its seat^'. ii — -12. 

Authoritative verses on the sub- 
ject : —Concretions, sands and sediments found to be 
deposited in the urine in a case of Bhashma-meha are but 
the modifications, or attendant symptoms of a case of 
stone in the bladder (Asmari). The same group of 
symptoms and the same kind of pain are exhibited and 
experienced in a case of gravel {S'arkard) as in a 
case of stone (Asmari) in the bladder. The local 
Vayu coursing in its natural direction helps the dis- 
charge of calculi (Asmari) with the urine in the 
event of they being extremely attenuated in structure. 
Particles of a stone broken by the Vayu are called 
urinary calculi {S'arkard). A pain about the cardiac 
recfion, a sense of weakness and lassitude in the thiojhs, 
a griping pain in the regions of the spleen and liver 
(Kukshi-sula), a shivering sensation, thirst, hiccough or 
eructations, darkness or sallowness of complexion, 
weakness, emaciation with a non-relish for food and 

* We can not but contemplate with admiration the fact that Sushruta 
was aware of the formation of seminal or spermatic concretions in the 
seminal vesicles through degenerative changes of spermatozoa and other 
secretions and their subsequent calcification as lately discovered by the 
savants of the "Wesi. — Translator 



Chap. III.] NIDANA STIIANAM. 29 

impaired digestion are the symptoms which are 
manifest in a gravel-patient. A gravel {S'arkard) 
obstructed at the mouth of the urinary channel is 
detected by the following indications : — viz., weakness, 
lassitude, emaciation, cachectic condition of the body, 
pain over the hepatic region (Kukshi-s'ula), a 
non-relish for food, sallowness of complexion, hot and 
high coloured urine, thirst, pressing pain at the cardiac 
region and vomiting. 13. 

The bladder is situated in the pelvic cavity, sur- 
rounded on its different sides by the back, loin (Kati), 
umbilicus, scrotum, rectum (Guda), groins and penis. 
This organ is provided with a single aperture or 
opening and lies with its mouth downward, covered with 
nets of nerves (Sira) and ligaments (Snayu), in the 
shape of a gourd. The organ is extremely thin in 
structure ; and thus situated within the pelvic cavity, it 
is connected, through its mouth or external orifice, with 
the rectum, the penis, and the testes. It is also known 
by the name of Maladhara (the receptacle of impure 
matter) and forms (one of) the primaiy seats of vital 
energy (Prana)*. The urinary ducts (ureters) pass close 
by the large intestines (Pakvas'aya) and constantly 
replenish the bladder and keep it moist with that waste 
product of the system in the same manner as rivers 
carry their contributions of water into the ocean. 
These passages or ducts (which are two) are found to 
take their origin from hundreds of branches (or 
mouths tubuli uriniferi), which are not visible to the 
naked eyes, on account of their extremely attenuated 
structures and carry, whether in a state of sleep or 
wakening, the urine from below the region of the 

* The text has Prdndyatanam^ which means that an injury to the 
urinary bladder may be attended with fatal result. 



30 THE SUSHRUTA SAMHITA. t^hap. III. 

stomach-f- (Amasaya) into the bladder keeping it filled 
with this important fluid of the body, just as a new- 
pitcher, immersed up to its neck in a vessel full of water, 
is filled by transudation through its lateral pores. 14. 

In the same way the Vayu, Kapham and Pittam are 
carried into the bladder (through their respective ducts 
or channels), and in unison with the retained urine, give 
rise to the formation of stone, on account of the slimy 
character of the deposit produced. Stone is formed in 
the same way in the bladder as sediments are ultimately 
deposited from clear and transparent water at the bottom 
of a new pitcher which contains it. As the wind 
and lightning jointly condense the rainwater into 
hailstones, so the bodily Vayu and Pittam (heat) jointly 
contribute to the condensation of the Kapham in the 
bladder and transform it into stone. 

The Vayu in the bladder, coursing in its natural 
downward direction, helps the full and complete 
emission of urine ; while coursing in a contrary direction, 
it gives rise to various forms of maladies such as, 
Prameha, strangury, as well as seminal disorders ; in 
short, it produces any urinary trouble to which the 
bladder may be subjected. 15. 

t From the kidneys. 

Thus ends the third Chapter of the Nidana Sthanam in the Sushruta 
Samhita which treats of the Nidanam of urinary calculi. 



CHAPTER IV. 

Now we shall discourse on the Nidatnam of Bhag^- 
ancla.ram (fistula m ano and fistular ulcers), i. 

The deranged Vayu, Pittam, Kaphah and Sannipatah 
(a simultaneous derangement of the three bodily Doshas) 
and extraneous causes (such as a blow etc.) give rise 
to the types of Bhagandaram known as Sataponaka, 
Ushtragriva, Parisrdvi, Samvukdvarta and Unmargi. 
The disease is so named from the fact that it bursts 
the rectum, the perineum, the bladder and the place 
adjoning to them (thus setting up a mutual communica- 
tion between them). The pustules, which appear in this 
regions are called as Pidakds in their unsuppurated 
stage, while they are called Bhagandaram when they are 
in a stage of suppuration. A pain about the sacral 
bone and an itching about the anus, accompanied by a 
swelling and burning sensation, are the premonitory 
symptoms of this disease. 2. 

The ^ataponakah Type :— The Vayu, 

excited, condensed, and rendered motionless by a course 
of unwholesome food, gives rise to a pustule within 
one or two fingers' length from the rectum (anal 
region, — Guda), by vitiating the flesh (areolar tissue) 
and blood (of the locality). It assumes a vermilion 
colour and is characterised by a variety of pricking, 
piercing pain. If neglected at the outset, the pustule runs 
into suppuration. Owing to its vicinity to the bladder, 
the abscess or the suppurated pustule exudes a kind of 
slimy secretion and becomes covered with hundreds 
of small sieve-like holes, through which a constant frothy 
discharge is secreted in large quantities. The ulcer, thus 
formed, seerns as if it is being thrashed with a rod, pierced 



32 THE SUSHRUTA SAMHITA. CChap. IV. 

with a sharp instrument, cut with a knife, and pricked by 
needles. The region of the anus cracks and bursts, and 
jets of urine, fecal matter, flatus (Vata) and semen 
are emitted through these sieve-like holes. This type 
of fistula is called Sataponakah (Sieve-like fistula 
in ano). 3. 

The Ushtra-grivah Type: -The enraged 

Pittam, carried down by the Vayu (into the rectum) finds 
lodgmeit therein, and there gives rise to a small, raised, 
red pustule, which resembles the neck of a camel in 
shape, and is characterised by a varied kind of pain, 
such as sucking etc. The pustule, not medicinally treated 
at the beginning, runs into suppuration. The incidental 
ulcer seems as if it is being burnt with fire or alkali, and 
emits a hot, fetid discharge. Jets of urine, flatus (Vata), 
fecal matter and semen flow out of the ulcer in the 
event of it not being healed up with proper medicinal 
remedies. This type is called Ushtragrivah. 4. 

The Parisravi Type: —The enraged Kaphah, 
carried down by the Vayu (into the rectum) and lodged 
therein, gives rise to a white, hard, itching pustule in that 
locality, characterised by a variety of itching pains, etc. 
If neglected at the outset, it soon runs into suppura- 
tion. The incidental ulcer becomes hard and swollen, 
marked by excessive itching , and a constant secretion of 
slimy fluid. Jets of urine, fecal matter, flatus and semen 
are emitted through the ulcer in the event of it not 
being well cared for at the outset. This type is called 
Parisravi. 5. 

The ^amvukavartah Type :— The en- 
raged Vayu, in conjunction with the aggravated Pittam 
and Kapham, is carried down, and finds lodgment (in 
the region of the rectum), giving rise to a pustule of the 
size of the first toe, and characterised by a piercing 



Chap. IV.] NIDANA STHANAM. 33 

pain, and burning, itching sensations etc. Such a pustule, 
neglected at the outset, speedily suppurates, and the 
incidental ulcer exudes secretions of diverse colours, 
characterised by a kind of whirling pain, which 
revolves about, in the direction of the involuted 
indentures (within the grooves of the rectum) such as 
are found within the body of a river or fresh water 
mollusc. This is called Samvukavartah. 6. 

The Unmargi Type :— Particles of bones, 
eaten with (cooked) meat by an imprudent, greedy, glut- 
tonous person, may be carried down with the hard and 
constipated stool by the Apana Vdyu (into the rectum), 
thus scratching or abrading the margin of the anus, or 
burrowing into the rectum in the event of their being 
evacuated in improper directions through (transverse or 
horizontal postures). The scratch or abrasion is soon 
transformed into a fetid and putrid ulcer, infested with 
worms and parasites, as a plot of miry ground 
will soon swarm with a spontaneous germination of 
similar parasites. These worms and parasites eat away 
the sides of, or largely burrow into, the region of the 
anus, and jets of urine, fecal matter, and flatus (VayuJ 
are found to gush out of these holes. This type of 
Bhagandaram is called Unmargi. 7. 

Authoritative verses on the sub- 
ject: — A pustule, appearing about the region of the 
anus and characterised by a slight pain and swelling, 
and spontaneously subsiding, should be regarded as a 
simple pustule, which is of a quite different nature 
from a fistula in ano, which has contrary features {i.e., 
invariably found to be attended with a violent pain 
and swelling etc., and takes a long time to heal). 
A Fistula-pustule crops up within a space of two 
fingers' width of the Pdyu proper (distal end of the 

5 



34 THE SUSHRUTA SAMHITA. [Chap. IV. 

rectum), is sunk at its root, and attended with pain 
and febrile symptoms. Pain, itching and burning 
sensations are experienced about the anus after a ride 
in a carriage, or after defecation. The anus becomes 
swollen, and the waist painful in the premonitory stages 
of Bhagandaram. 8—9. 

Prognosis : — Almost all the types of this 
disease (Fistula in anoj yield to medicine after a 
prolonged course of treatment, and are hard to cure, 
except the Sannipatah and traumatic ones, which are 
incurable. 10. 

Thus ends ihe fourth Chapter of the Nidana Sthanam in the Sushrula 
Samhila, which treats of the Nidanam of Fistula in ano (Bhagandaram). 



CHAPTER V. 

Now we shall discourse on the Nidatnam of Kush- 
tham (cutaneous affections in general), i. 

Improper diet or conduct; especially ingestion of 
improper, unwholesome, indigestible, or inconge- 
nial food ; physical exercise or sexual intercourse 
immediately after partaking of any oleaginous subs- 
tance, or after vomiting ; constant use of milk in com- 
bination with the meat of any domestic, aquatic 
or amphibious animal ; a cold water bath after an 
exposure to heat ; and repression of any natural urging 
for vomiting etc. are the factors which tend to derange 
and aggravate the fundamental principle of Vayu in a 
person. The enraged or aggravated Vayu, in combina- 
tion with the agitated Pittam and Kapham, enters into 
the vessels or ducts fSira), which transversely spread 
over the surface of the body. Thus the enraged Vayu 
deposits the Pittam and Kapham on the skin through the 
medium of their channels and spreads them over the 
entire surface of the body. The regions of the skin in 
which the aforesaid morbific diatheses are deposited 
become marked with circular rings or patches. The mor- 
bific diatheses (Doshas), thus lodged in the skin, continue 
to aggravate, and having been neglected at the outset, 
tend to enter into the deeper tissues and thus contaminate 
the fundamental principles (Dhatus) of the body. 2. 

Premonitory Symptoms : — A roughness 

of the skin, sudden horripilation, an itching sensation in 
the surface of the body, excess or absence of perspiration, 
anaethesia of the parts, a black colour of the blood, and 
a rapid growth and expansion of any ulcer (appearing on 
the body) are the symptoms which mark the premoni- 
tory stages of Kushtham. 3. 



36 THE SUSHRUTA SAMHITA. tChap. V. 

Classification :— [Diseases, falling under the 
group of Kushtham, may be divided into two broad 
subdivisions], viz.,— Mahdktishthas (major) and Kshudra 
{minor) Kushthas, the first consisting of seven, and the 
second of eleven different types, aggregating eighteen 
in all. The Mahakushthas are classified as, Aruna, 
Audumvara,Rishya-Jihva, Kapala, Kakanaka, Pundarika, 
and Dadru. The minor or Kshudra-kushthas (Lichen and 
Dermatitis) are Sthularushkam, Mahakushtham, Eka- 
kushtham, Charmadalam, Visarpah, Parisarpah, Sidhma, 
Vicharchika, Kitima, Pama, and Rakasa. All the types 
of Kushtham, whether major or minor, involve the action 
of the deranged Vdyu, Pittam or Kapham, and are con- 
nected with the presence of parasites in those localities * 
The preponderance of any particular morbific diathesis 
(Dosha) in any case of Kushtham should be looked upon 
as its originating cause. The type, known as Aruna 
Kushtha, is due to the action of the preponderant Vayu ; 
Audumvara, together with Rishya-Jihva, Kapala and 
Kakanaka, to a preponderance of the deranged Pittam ; 
while Pundarika and Dadru owe their origin to an 
excess of the deranged Kapham. These types of major 
or minor Kushthas are successively more extensive in 
their action and more incurable on account of their 
respectively invading a greater number of the bodily 
elements (Dhatus). 4 — 6. 

Mahakushthas :— Aruna-kushtha owes its 
origin to an exuberance of the deranged Vayu. It is 
slightly vermilion-coloured, thin and spreading in its 

* Certain authorities hold that, all types of Kushtham (cutaneous 
affections) to be of parasitic origin. The Garuda Puranani avers that, the 
parasites, which infest the external principles of the body, are the primary 
causes of cutaneous Sif^eclions—A'iishtAaika'heiavoniafy'dk shlemshajd 
v6hyasambhavdli, Ch. CLXIXV. 4. 



Chap, v.] KlDANA STHAKAM. 37 

nature. A sort of pricking, piercing pain (is experienced 
in the affected locality) which loses all sensibility to 
the touch. The type known as Audumbara is coloured 
and shaped like a ripe or mature Audumbara fruit 
and has its origin in the deranged Pittam. The type 
called Rishyajihva is rough and resembles the tongue 
of a Rishya (Deer) in shape and colour. The type 
known as Kapaila (Macula cserula^) resembles a black 
(deep blue) Kharpara ( baked clay ). The Katkanaka 
type is characterised by a dark red and black colour 
like the seed of the Guiija berry. A sort of sucking 
and burning pain is experienced in the affected 
locality in all the four preceding types of the disease 
which are the outcome of the deranged Pittam. The 
whole diseased surface seems as if burning with fire, 
and emitting hot fumes. They are speedy in their 
origin and rapidly suppurate and break. All these 
types soon become infested with parasites. These 
are the general features of these forms of Kushthas. 7. 

Pundarika:— The patches resemble the petals 
of a (full blown) lotus flower in colour, and Dadru 
(Ringworm) assumes the colour ffaint blue) of an 
Atasi flower, or of copper. They are spreading in their 
nature and are found to be overspread with pustules. 
Both the Dadru and Pundarika types are raised, circular, 
and characterised by itching and take a considerable 
time to be fully patent. These are the general charac- 
teristics of Dadru and Pundarika. 8. 

Kshudra Kushthas :— We shall now des- 
cribe (the features of the diseases known as) Kshudra- 
knshthas (M. Text):— The type known as Sthula'rushka 
appears about the joints. It is extremely thick at its 
base, is cured with the greatest difficulty, and is strewn 
over with hard pustules (Arungshi). In the type known 



3^ THE SUSHRUTA SAMHITA. [Chap. V. 

as of Mahatkushtham the skin contracts, and with the 
bursting of the skin (a piercing pain is felt in the affec- 
ted part), which loses all sensibility to the touch, accom- 
panied by a general sense of lassitude in the limbs. In 
the Ekakushtham (Ichthyosis) type the skin assumes a 
reddish black colour. It is incurable. In the form known 
as Charmadalam (Hypertrophy of the skin) a burning, 
sucking, drawing pain is experienced in the palms of the 
hands and in the soles of the feet which become cha- 
racterised with an itching sensation. The disease, which 
affects in succession the (organic principles of) skin, 
blood and flesh, and speedily extends all over the body, 
like Erysipelas, and is attended with a burning sensation 
fVidaha), restlessness, suppuration and a piercing pain 
and loss of consciousness (epileptic fits), is called Visarpa 
Kushtham. The form in which a number of exuding 
pustules gradually extend over the surface of the body 
is called Parisarpa Kushtham. The type of the disease 
which is white and thin, and is characterised by itching 
and does not create any disturbance (in the patient), is 
called Sidhma (Maculae atrophicae). This form is generally 
found to restrict itself to the upper part of the body. 
Vicharchika (Psoriasis) is characterised by excessive pain 
and itching and gives rise to extremely dry crack-like 
marks on the body [hands and feet]. The same form of 
malady attended with pain, burning and itching, and 
restricting itself solely to the lower extremities, is called 
Vipatdikat. The type in which the eruptions exude (a 
kind of slimy secretion) and which are circular, thick, 
excessively itching, glossy and black-coloured is called 
Kitima (Keloid tumours). Small pustules or pimples 
characterised by an itching, burning secretion and 
appearing on the surface of the body are called Fakma 
(Eczema). The preceding kinds of pimples attended 



Chap, v.] NIDANA STHANAM. 39 

with burning vesicles, are called Kachchus and are 
found to be chiefly confined to the legs, hands and 
buttocks. A sort of dry and non-exuding pimples 
characterised by excessive itching and appearing all 
over the body, is called Rakasai (dry Erythema). 9-10. 

The forms known as Sthularushka, Sidhma, Rakasa, 
Mah^kushtham and Ekakushtham should be considered 
as offspring of the deranged Kapham. Parisarpa-kush- 
tham alone is due to the action of the deranged Vayu, 
while the remaining types (of minor Kushtham) owe 
their origin to the action of the deranged Pittam. ii. 

Kilasam : — The disease known as Kilasam is 
but another form of Kushtham. It may be divided into 
three types according as it is brought about through 
the action of the deranged Vayu, Pittam or Kapham. 
The difference between Kilisam and Kushtham is that 
the former confines itself only to theTvaka (the skin)and 
is marked by the absence of any secretion.* A case of 
Kilasam caused by the action of the deranged Vdyu is 
circular, vermilion-coloured and rough to the touch. The 
affected part when rubbed peals off scales of morbid skin. 
A case of Kilasam, due to the action of the deranged 
Pittam, is marked by eruptions, resembling the petals 
of a lotus flower (in shape and colour), and are attended 
with an extremely burning sensation. In the type 
originated through the action of the deranged Kapham, 
the affected part (skin) assumes a glossy, white colour, 
becomes thick and is marked by an itching sensation. 
The form in which the eruptions or patches extend and 
become confluent, invading even the soles of the feet, 

* A case of Kushtham has its primary seat ir\ the blood and skin (of the 
patient), in which it lies confined during the period of incubation, after 
which it attacks the skin and secretes the characteristic secretion of the 
deranged Dosha involved in it* 



40 THE SUSHRUTA SAMHITA. [Chap. V. 

the palms of the hands and the region of the anus, and in 
which the local hairs assume a red colour should be 
regarded as incurable. A case of Kilasham, which is 
the outcome of a burn (cicatrix) should be likewise con- 
sidered as incurable. 12. 

A preponderance of the deranged Vayu in a case of 
Kushtham (leprosy) is indicated by a contraction of the 
skin, local anaesthesia, a copious flow of perspiration, 
swelling, and piercing or cutting pain in the affected part, 
together with a deformity of the limbs and hoarseness. 
Similarly, an excess of the deranged Pittam in a case of 
Kushtham, should be presumed from the suppuration of 
the affected part, from the breaking of the local skin, 
from the falling off of the fingers, from the sinking of 
the nose and ears, from the redness of the eyes and from 
the germination of parasites in the incidental ulcer. An 
excessive action of the deranged Kapham, in a case of 
Kushtham, gives rise to itching, discolouring and swelling 
of the affected part which becomes heavy and exudes 
the characteristic secretion. The types, Pundarika and 
Kakanam, which are due to the germinal defect of 
the patient, are incurable, inasmuch as they involve 
(according to Dallana) the concerted action of the 
three simultaneously deranged Doshas from the very 
outset. 1 3 . 

Memorial verses :-~As a tree, full grown in the 
course of time, has driven its roots, which derive their 
nourishment from the rain water, deeper and deeper 
into the successive strata of the soil, so this disease 
(Kushtham), first affecting and confining itself to the 
upper layers of the skin, will invade the deeper tissues 
and organs etc. of the patient, if unchecked until al- 
most all the fundamental principles or elements Dhdtus 
are attacked by its virus in the course of time. 14. 



Chap, v.] NibANA STHANAM. 4t 

The symptoms of a case of Kushtham confined only 
to the serous (Tvaka) fluid of the skin are the loss of the 
perception of touch, a scanty perspiration, itching and dis- 
coloration and roughness of the affected part. The symp- 
toms which manifest themselves when the disease is con- 
fined to the blood are complete anaesthesia, horripilation, 
absence of perspiration, itching and excessive accumu- 
lation of pus in the affected parts. The symptoms of 
Kushtham affecting only the flesh are thickness of the 
patches, dryness of the mouth, roughness and hardness 
of the patches which become covered with pustular 
eruptions and vesicles, and an excruciating pricking pain 
in, and numbness of, the affected part. The symptoms 
of (Kushtham) invading the principle of fat only are a 
fetid smell and an excessive accumulation of pus in the 
affected part and a breaking of the skin, exposing deep 
gashing wounds which soon become infested with para- 
sites. The body seems as if covered with a plaster. 
Symptoms of (Kushtham) affecting only the bones and 
the marrow are a sinking (lit: breaking) of the nose, a 
redness of the eyes, loss of voice and the germination 
of parasites in the incidental ulcers. Symptoms of the 
disease restricting itself only to the principle of semen 
are a crippled state of the hands and distortion of the 
limbs, loss of the power of locomotion, spreading of 
ulcers and all the other symptoms peculiar to the pre- 
ceding types of the disease. 15 — 20. 

A child, which is the offspring of the contaminated 
semen and ovum of its parents afflicted with Kushtham, 
should be likewise regarded as a Kushthi. 21. 

Prognosis: — A case of Kushtham appearing 
in a person of prudence and discretion and confined 
only to the serum (Tvaka), flesh and blood of his orga- 
nism should be regarded as curable. A palliative treat- 

6 



42 THE SUSHRUTA SAMHlTA. [Chap. V. 

ment is the only remedy in cases where the disease is 
found to invade the principle of fat ; whereas a case 
where the poison is found to have penetrated into 
any of the remaining organic principles should be given 
up as incurable. 22, 

Wise men hold that, for killing a Brahmana, or a wo- 
man, or one of his own relations, for theft, as well as for 
doing acts of impiety, a man is sometimes cursed with 
this foul disease by way of divine retribution. The disease 
reattacks a man even in his next rebirth in the event of 
his dying with it. Uncured Kushtham (leprosy) is the 
most painful, and most troublesome of all diseases. 23 — 24. 

A Kushthi (leper), getting rid of this foul malady by 
observing the proper regimen of diet and conduct and 
by practising expiatory penances and by resorting to 
proper medicinal measures, gets an elevated status after 
death. 25. 

Kushtham (Leprosy) is a highly contagious disease ; 
the contagion being usually communicated through 
sexual intercourse with a leper (Kushthi), or by his touch 
or breath, or through partaking of the same bed, and 
eating and drinking out of the same vessel with him, or 
through using the wearing apparel, unguents and 
garlands of flowers previously used by a person afflicted 
with this dreadful disease. Kushtham (Leprosy), fever, 
pulmonaiy consumption, ophthalmia and other Aupasar- 
gika disease (incidental to the influences of malignant 
planets or due to the effects of impious deeds) are 
communicated from one person to another. 26. 

Thus ends the fifih Chipter of the Nidanaslhanam in the Sushruta 
Samhila which treats of the Nidanam of cutaneous affections (Kushtham). 



CHAPTEE VI. 

Now we shall discourse on the Nidanam of Pra- 
meha (diseases of the urinary tracts), i. 

It may be prognosticated that an idle man, who 
indulges in day sleep, or follows sedentary pursuits or 
is in the habit of taking sweet liquids, or cold and 
fat-making or emollient food, will ere long fall an easy 
victim to this disease. 2. 

Pathology : —The bodily principles of Vdyu, 
Pittam and Kaphah of such a person get mixed with 
improperly formed chyle of the organism. Thus deranged, 
they carry down through the urinary ducts the de- 
ranged fat, etc.* of the body and find lodgment at the 
mouth (neck) of the bladder, whence they are emitted 
through the urethra -t", causing diseases, known by the 
(generic) name of Prameha. 3 

Premonitory symptoms: -A burning 
sensation in the palms of the hands and of the soles of 
the feet, a heaviness of the body, coldness or sliminess 
of the skin and limbs, sweetness and whiteness of 
the urine, somnolence, lassitude, thirst, a bad-smelling 
breath, a shortness of breath, slimy mucous deposit on the 
tongue, palate, pharyx and teeth, clotted hair and an in- 
ordinate growth of the finger and toe nails are the 
indications which mark the advent of the disease. 4. 

General Characteristics:— A copious flow 

of cloudy or turbid urine characterises all the types of 
the disease, which, together with the abscesses and 
eruptions (Pidaka) which mark its sequel, should be 

* The particle "cha" in the text denotes other virus or morbific 
matter. Dallana. 

t Remain incarcerated therein according to others. 



44 THE SUSHRUTA SAMHITA. [Chap. VI. 

regarded as involving the concerted action of the de- 
ranged Doshas (Vayu, Pittam and Kaphah). 5. 

The Kaphaja Types : —Cases of Prameha, 
which are caused by an exuberance of the deranged 
Kapham, may be grouped under ten subheads such as, 
Udaka-meha, Ikshu-meha, Sura-meJia, Sikata-meha, S'a- 
nai-meha, Lavana-meha, Pishta-meha, Scindra-meha, S'uk- 
ra-meha and Phena-meha. The ten aforesaid types are 
curable, inasmuch as the medicines which tend to remedy 
the deranged Kapham (Dosha), the cause of the disease, 
prove also remedial to the other principles of the body 
(flesh, marrow, blood, semen etc.) deranged (Dushya) 
from the same causes. 6. 

The Pittaja Types : — The types, which are 
brought about through an exuberance of the deranged 
Pittam, are named as Nila-meha, Haridrd-meha, Amla- 
meha, KsJiara-meha, ManjisJitha-ineha^ and S'onita-meha, 
Palliation is all that can be effected in these types, 
inasmuch as the medicines which tend to correct the de- 
ranged Pittam, which has brought on the disease, fail 
to exert similar virtues on the organic principles 
(Dushyas) deranged by it. 7. 

The Vataja Types :— The types of Prameha 
which are produced by an aggravated condition of 
the bodily Vayu are divided into four subgroups, such as 
Sarpi-ineha, Vasd-meha, Kshoudra-meha and Hasti-ineha. 
These should be regarded as most incurable inasmuch as 
no kind of medicine can restore the fleet-coursing, deep 
diving {ie. invading the bones and the marrow) Vayu, 
which at the same time also augments the Pittam, to its 
normal state and thus advances (unchecked) in its work 
of disintegration. 8. 

The deranged Kaphah, in conjunction with the 
(morbid) Pittam, Vayu and fat, gives rise to all Kaphaja 



Chap. VI. NIDANA STHANAM. 45 

types of Prameha. The deranged Pittam, in conjunc- 
tion with the deranged Vayu, blood, fat and Kapham, 
produces the Pittaja ones ; while the deranged Vayu, in 
unison with the deranged Kapham, Pittam, fat, marrow 
and Vasa (myosin), engenders the types of Vataja 
Prameha. 9. 

Symptoms of Kaphaja IVIehas : -The 

urine* of a person suffering from an attack of Udaka- 
meha becomes white and water-like and is passed without 
the least pain. In a case of Ikshumeha the urine 
resembles the expressed juice of sugarcane. It has the 
colour of wine in a case of Surameha. The urine in a 
case of Sikatameha is passed with pain and is found 
to leave a sediment of extremely fine and sand-like 
concretions {Sikatas). In a case of Sanaimeha the 
urine gushes out at intervals in jets and is charged 
with a slimy mucous (kaphah). The urine in a case of 
Lavauameha becomes limpid (non-viscid) and acquires 
a saline taste. There is horripilation at the time of 
micturition in a case of Pishtameha (Chyluria), the 
urine resembling a stream of water, charged with a 
solution of pasted rice (Pishtam). 

In a case of Sandrameha, the urine becomes 
thick and turbid, while in a case of Sukrameha 
the urine resembles semen (or the urine is found to 
be charged with semen : — Madhaba). In a case of 



* Tl e Sanskrit term Meha literally means to micturate. The verbal 
noun Mehanam signifies utination as well as the act of passing any morbid 
urethral secretion. Hence the urine in most of these cases denotes the 
fact of its being charged with pus or any other morbid secretion of the 
urinary oigans such as Ojah (albumen), marrow, etc., which imparts tluir 
characteristic colours to the fluid, —a fact which determines the nomen- 
clature of the disease and forms the keynote of its diagnosis in the 
Ayurveda.— Ed. 



46 THE SUSHRUTA SAMHITA. [Chap. I. 

Phenamelia the patient passes frothy urine in broken 
jets. lo. 

Symptoms of Pittaja Mehas :— Now we 

shall describe the characteristic features of the types 
of Prameha, which are due to the action of the deranged 
Pittam. The urine in a case of Nilameha becomes 
frothy, transparent and bluish. The urine in a case of 
Haridrameha becomes deep yellow like turmeric 
(Haridra) and is passed with a burning pain. The 
urine in a case of Amlameha acquires an acid taste and 
smell. The urine in a case of Kshairameha* resembles 
an alkaline solution filtered (through a piece of linen). 
The urine in a case of MaDJisthameha resembles the 
washing of the Manjistha, while in a case of Raktameha, 
the urine is found to be of blood-colour ^or charged with 
blood - Madhava). 1 1 . 

Symptoms of Vataja-IVIehas :— Now we 

shall describe the characteristics of the different types of 
Prameha, which are due to an exuberance of the 
deranged Vayu. In a case of Sarpimeha, the urine 
looks like a stream of clarified butter, while in one of 
Vasatmeha it resembles the washings of Vasa. In a case 
of Kshaudrameha, the urine looks like honey and 
acquires a sweet taste. In one of Hastimsha, the 
patient passes a copious quantity of urine, like an 
excited elephant, at a time, and in one unbroken stream, 
(the organ becoming steady immediately after the act 
of micturition). I2. 

Supervening" symptoms :— The fact of 

the urine being assailed by a swarm of flies, lassitude, 
growth of flesh (obesity), catarrh, looseness of the limbs, a 

* The urine acquires a distinct alkaline taste, smell, colour and touch. 
(Madhaba Nidanam). 

f Charaka has included it within Kshaudra Meha and Madhu Me a. 



Chap. VI.] NIDANA STHANAM. 47 

non-relish for food, Indigestion, expectoration of mucous, 
vomiting, excessive sleep, cough and laboured breathing 
(Svasa) are the supervening traits (Upadrava) of the 
Kaphaja Prameha. A piercing pain in the testes, a 
pricking (veda) pain in the bladder, a shooting pain 
(Tuda) in the penis, a griping pain at the heart, acid 
eructations, fever, dysentery, a non-relish for food, 
vomiting, a sensation as if the entire body is emitting 
fumes, a burning sensation in the skin, thirst, 
epileptic fits, insomnia, jaundice (Pandu) and a yellow 
colour of the stool and urine are the supervening 
symptoms which mark the Pittaja types of Prameha. 
An oppressive feeling at the heart (Hridgraha), eager 
longings for foods of all tastes, insomnia, numbness 
of the body, fits of shivering, colic pain and constipation 
of the bowels are the supervening symptoms, which 
specifically mark the Vataja types. Thus we have 
described the nature of the twenty different types of 
Meha with their supervening evils as well. 13-16. 

The ten different types of Pidaka (abscess, carbun- 
cles, pimples, pustules etc.) are found to crop up on the 
bodies of patients, suffering from Prameha, and abounding 
in fat and Vasa, and whose fundamental principles have 
been affected by the simultaneous derangement of 
the Vayu, Pittam and Kapham. They are named as 
Siravikat, Sarshapika, Kachchapika; Jaiini, Vinat^, 
Putrini, Masurika, Alaji, Vids^rika and Vidradhikab. \7 - 

IVIctrical Texts : — An abscess which is raised 
at the margin and dipped in its centre, so as to resemble 
an Indian saucer in its shape is called Saravik^. Pimp- 
les or pustules of the shape and size of white mustard 
seeds are called Sarshapikat. An abscess, resembling 
(the back of) a tortoise in shape and attended with a 
burning sensation, is called Kachchapika by the wise. 



48 THE SUSHRUTA SAMHITA. [C^i^P- ^^» 

An abscess studded with slender vegetations of flesh and 
attended with an intolerable burning sensation is called 
Jg^lini. A large blue-coloured abscess (carbuncle) 
appearing on the back or the abdomen, and exuding a 
slimy secretion and attended with a deep-seated pain is 
called Vinatat A thin and extensive abscess (studded 
withslender pustules —D.R.) is called Putrini. Pimples to 
the size of lentil seeds are called Masurika. A dreadful 
abscess which is of a red and white colour, studded over 
with blisters or exuding vesicles is called Alaji. A hard 
and round abscess as large as a (full-grown) gourd is 
called Vidai'ikat. An abscess of the Vidradhi type is 
called Vidradhika (carbuncle) by the wise. An incidental 
abscess in a case of Prameha should be regarded as 
having its origin in the same morbific principle (Dosha) 
as that which has produced the disease (Prameha) 18-28. 

Prognosis : — A Pidaka,or an abscess, appearing 
about the region of the heart, anus, head, shoulder, back 
or at any of the vital joints (Marma) of the body, and 
attended with other supervening symptoms producing 
extreme prostration [impaired digestion — D." R.] in 
the patient should be abandoned as incurable. In 
a case of Vataja meha, the deranged Vayu presses 
all the fundamental principles out of the body through 
the urethra and rages rampant in the lower part of the 
body, united with the deranged fat, marrow and Vasa. 
Hence a case of Vataja meha, (or its accompanying 
abscess), is held as incurable. 29-30. 

A person in whom the premonitory symptoms (Pur- 
varupam of Prameha) have appeared and who passes 
a little larger quantity of urine than usual, should be 
considered as already afflicted with it. A person 
afflicted with all or half of the premonitory symptoms 
of the disease and passing a copious quantity of urine 



Chap. VI. NIDANA STHANAM. 



49 



should be considered as one suffering from an attack 
ofPrameha. 31 — 32. 

A Prameha patient afflicted with deep-seated absces- 
ses and other distressing symptoms, which are usually 
found to supervene in the disease, should be pronounc- 
ed as suffering from Madhumeha and adjudged incurable. 
A Madhumeha patient seeks a halting place while walk- 
ing, wants a place to sit on while halting, lies down if he 
finds a sitting place, and sleeps if he lies down. 33 — 34. 

As five mixed colours such as grey, brown, Kapila 
(bluish yellow), Kapota (blackish grey), Mechaka 
(light-green) may be produced by combination of the 
five primary colours in definite proportions (such as 
white, green, black, yellow and red), so a diversity of 
causes, through the relative preponderance of the parti- 
cular kinds of food, and of the deranged Doshas, root 
principles (Dhatu) and excretions of the body (Mala), 
may be attributed to the origin of Prameha. 35. 

IVIemorial verses :— All types of Prameha, 
not properly treated and attended to at the outset, 
may ultimately develop into those of Madhumeha 
types, which are incurable. 36 

For English equivalents of the different types of Prameha compare : — 
Cystitis (Acute Infective) — Frequent, painful micturition, small quantity 
of urine voided with pain and urgency. Urine — slightly acid or alkaline in 
reaction, cloudy, containing blood corpuscles. Cystitis (Chronic Infective) 
— Great and frequent pain, in the lumbar region, rigor. Urine — thick, 
offensive and alkaline, containing ropy mucous and blood. Cystitis (Non- 
Infective) — Symptoms like those of acute inflammatory type. Urine- 
acid and cloudy with mucous. Blood is generally present in 
considerable quantity. Neuralgia of the bladder, compare Albuminuria, 
Albumosuria, Hoemoglobinuria, Hoematuria, Peptonuria, Pyuria, 
Spermatorrhoea and Diabetes, Proteuria and Polyuria. 

Thus ends the sixth Chapter of the Nidana Sthanam in the Sushruta 
Samhit^, which treats of the Nidanam of Prameha. 



QS 



CHAPTER YII. 

Now we shall discourse on the Nidainam of Udara 

(dropsy with an abnormal condition of the abdomen), i. 

Metrical Text :— The royal sage Dhanvan- 
tari, the foremost of all pious men who equalled 
in splendour and glory the lord of the celestials, thus 
blissfully discoursed on the Niddnam of Udara to 
Susruta, the son of the holy Vis'vamitra, who devoutly 
approached him for that purpose. 2. 

Classification : — This disease may be divided 
into eight different types, of which four are produced 
by the several actions of the three deranged Doshas of 
the body and their concerted action as well. Of the re- 
maining types, two being known as Plihodara (including 
Yakritodara), and Vaddha-Gudodara (tympanites due to 
the constriction of the anus), the seventh Agantuka 
(traumatic or of extraneous origin), and the eighth 
Dakodara (Ascites proper). 3. 

Predisposing Causes :— The deranged 

Doshas of a person of extremely impaired digestion, 
addicted to the habit of taking unwholesome food, or 
of eating dry, putrid food, or of violating the rules of 
conduct to be observed in connection with oleaginous 
measures etc.,* are aggravated and find lodgment in the 
abdomen. Thus appearing in the shape of an abdomi- 
nal tumour (Gulma), they give rise to this dreadful disease, 
attended with all its characteristic symptoms. The lymph 
chyle formed out of the assimilated food getj vitiated, 
and, impelled by the aggravated Vdyu, it percolates 

* These include purgative, erpitic, A'stha'panam and Anuva'sapann 
p(iej^su|re§, 



k 



th«p. VII.] NIDANA STHANAM. Jt 

through the peritoneum in the same manner as a quantity 
of oil or clarified butter kept in. a new, earthen pot will 
transude through the pores of its sides. It thus gradually 
distends the skin (Tvak) of the abdomen. The process 
becomes general all through the abdominal region and 
the disease (Udara) is produced in consequence. 4 — 5. 

Premonitory sypmtoms :— The precursory 

symptoms of the disease are loss of strength, complexion 
and appetite, emaciation of the muscles of the abdomen, 
appearance of veins on its surface, acid reaction of food 
closely following upon its digestion (Viddha\ pain 
in the bladder, and swelling of the lower extremities. 
The patient cannot ascertain whether his meal has been 
digested or not. 6. 

The Vataja, Pittaja, and Kaphaja 

Types : — A case of Udara in which the abdomen en- 
larges on its sides and posterior part, and is over- 
spread with nets of black veins should be ascribed to the 
action of the deranged Vdyu. A pain (Sula), suppression 
of the stool and urine (Andha) and a cutting and piercing 
pain and flatulent rumbling in the intestines are the symp- 
toms which likewise characterise this Va'taja form of 
Udara. A sucking pain in the abdomen, thirst, fever with 
a burning sensation, yellow colour of the swollen skin of 
the abdomen, on the surface of which yellow veins 
appear, yellow colour of the eyes, nails, face, stool and 
urine and the rapid increase of the dropsical swelling, are 
the characteristics of the Pittaja Udara. In a case of 
Kaphaja type the dropsical swelling is cold to the touch 
and becomes overspread with white-coloured, veins. 
The abdomen seems heavy , hard, glossy and is extreme- 
ly distended. The swelling slowly increases, and the finger- 
nails and face of the patient become white, and he 
complains of a general lassitude. 7 — 9. 



52 THE SUSHRDTA SAMHITA. tChap. VIl. 

The TridOShaja Type :— Evil-natured wo- 
men (with a view to win the affections of their husbands 
or lovers sometimes) mix with their food and drink such 
refuse matters of their bodies as nails, hair, faeces, urine, 
catamenial blood etc. (which are supposed to be possessed 
of talismanic virtues). The three Doshas of the body, vitia- 
ted by such food or drink, or through imbibing any sort of 
chemical poison (Gara) administered by one's enemy, or 
by taking poisonous waters, or Dushi-Visha (slow poison 
whose active properties have been destroyed by fire or 
any antipoisonous medicine), will vitiate the blood and 
give rise to a kind of dreadful dropsical swelling of the 
abdomen, marked by the specific symptoms of each 
of them The disease is aggravated in cold and cloudy 
days and a burning sensation is felt (in the inside of 
the abdomen\ The patient becomes pale, yellow and 
emaciated, and is afflicted with thirst and dryness in the 
mouth, and loses consciousness at short intervals. This 
disease is also known as the dreadful Dushyodaram. lo. 
Plihodaram. — (Spleen with dropsy of the abdo- 
men) : — -Now hear me describe the symptoms of Pliho- 
daram. The blood and the Kapham of a person, derang- 
ed and aggravated through the ingestion of phlegma- 
gogic food, or of those which is followed by an acid 
digestionary reaction (Viddha), often enlarge the spleen, 
(which gives rise to a swelling of the abdomen). This 
disease is called Plihodara by the experts. Plihodaram 
protrudes on theleft sideof the abdomen, its characteristic 
symptoms being lassitude, low fever, impaired digestion, 
loss of strength, jaundice, weakness, and other distress- 
ing symptoms peculiar to the deranged Pittam and 
Kapham. A similar enlargement of the liver through 
similar causes on the right side of the abdomen is 
called Jakriddfitly udarani. 1 1 — 1 2. 



Chap. Vll.] NIDANA SfHAJSTAM. ^3 

Vaddha-gUdOdaram* :— The fecal matter, 
mixed with the deranged Vayu, Pittam etc. of the 
body, lies stuffed in the rectum of a person whose in- 
testines have been stuffed with slimy food (as pot herbs) 
or with stones and hair (enteritis). They give rise to 
a sort of abdominal dropsy by swelling the part between 
the heart and the umbilicus which is called Vaddha 
Gudodaram. Scanty stools are evacuated with the great- 
est pain and difficulty and the patient vomits a pe- 
culiar kind of matter with a distinctly fecal smell 
(scyabalous ?). 13. 

Parisravi-Udaram : — Now hear me describe 
the causes and symptoms of the type of Udaram which 
is called Parisratvi-udaram. Thorny or sharp-pointed 
substances (such as fish-bones etc.), carried down with 
the food in a slanting way from the stomach into the 
abdomen, sometimes scratch or burrow into the intes- 
tines. Causes other than the preceding ones, (such as 
a long yawn or over-eating etc.) may contribute to the 
perforation of the intestines, giving rise to a copious 
flow of a watery exudation which constantly oozes out 
of the anus and to a distension of the lower part of the 
abdomen situated below the , umbilicus. This is called 
Parisravy udaram which is marked by a cutting pain and 
a burning sensation. 14. 

Dakodaram : — Now hear me describe the 
causes and symptoms of the type known as Dakodaram 
(ascites). The drinking of cold water immediately after 
the application of an Aunvdsanam or Asthapanam 
enema, or closely following upon the exhibition of any 
purgative or emetic medicine, or just after the taking of 
a medicated oil or clarified butter, etc. tends to derange 

* Dropsical swelling of the abdomen with tympanites due to the cons- 
triction of the rectum known as intestinal obstruction. 



54 THE SUSHRUTA SAMHITA. ' [Chap. VII. 

the water-carrying channels of the body. The same result 
may be produced by the drinkmg of oil, etc. in inordi- 
nate quantities The water, by percolating or transud- 
ing through the walls of these channels, as before des- 
cribed, inordinately enlarges the abdomen, which be- 
comes glossy on the surface and is full of water, being 
rounded about the umbilicus and raised like a full- 
bloated water-drum. The simile is complete as it 
fluctuates under pressure, oscillates, and makes a pecu- 
liar sound like a water-drum under percussion. 15. 

Distension of the stomach, incapacity of locomotion, 
weakness, impaired digestion, cedematous swelling of 
the limbs, a general sense of lassitude and looseness in 
the limbs, suppression of flatus and stool, and a burning 
sensation and thirst are among the general characteris- 
tics of the disease in its various forms. 16. 

Prognosis : — All cases of Udaram after the 
lapse of considerable time develop into those of ascites, 
and a case arriving at such a stage should be given up as 
incurable. 16 — 17. 

Thus ends the seventh Chapter of the Nidana Slhanam in the Sub'ruta 
Samhita which treats of the Nidanam of Udaram. 



CHAPTER Vm. 

Now we shall discourse on the Nidanam of 
IVlUClhagarbham (false presentations and difficult 
labour), i. 

Causes of lYIudha-garbham : -Sexual 

intercourse during pregnancy, riding on horseback, etc., 
or in any sort of conveyance, a long walk, a false step, a 
fall, pressure on the womb, running, a blow, sitting or 
lying down on an uneven ground, or in an uneven 
posture, fasting, voluntary repression of any natural 
urging of the body, partaking of extremely bitter, 
pungent, parchifying articles, eating in inordinate quan- 
tities of Sakas and alkaline substances, dysentery 
(Atisdra), use of emetics or purgatives, swinging in a 
swing or hammock, indigestion, and use of medicines 
which induce the labour pain or bring about abortions, 
and such like causes tend to expel the faetus from its 
fixture. These causes tend to sever the child from the 
uterine wall with its placental attachment owing to a 
kind of Abhighatam (uterine contraction) just as a blow 
tends to sever a fruit from its pedicel. 2. 

Definition:— The faetus, thus severed and 
dislodged from its seat, excites peristalsis not only in 
the uterus, but induces a sort of constant, spasmodic 
contraction of the intestinal cavities (Koshthas), pro- 
ducing pain in the liver, spleen, etc. The Apana Vayu, 
thus obstructed through the spasmodic contraction 
of her abdomen, produces any of the following symp- 
toms, viz. a sort of spasmodic pain in the sides, or 
in the neck of the bladder, or in the pelvic cavity, 
or in the abdomen, or in the vagina, or Andha (tymp- 
anites with obstruction, etc,) or retention of urine, 



^6 THE SUSHRUTA SAMHITA. tChap. VIII. 

and destroys the faetus, if immature, attended with 
bleeding. In case the faetus continues to develop 
and is brought in an inverted posture at the entrance 
to the vaginal canal, and is impacted at that place, 
or if the Apana Vdyu gets disordered and conse- 
quently cannot help the expulsion of the same, such 
an obstructed faetus is called Mudhagarbhah. 3. 
Classification and Symptoms: -Cases 

of Mudha-garbha may be roughly divided into four 
different classes such as, the Kilah, the Pratikhurah, 
the Vijakah and the Parighah. The sort of false 
presentation in which the child comes with its hands, 
legs and head turned upward and with its back firmly 
obstructed at the entrance to the vagina, like a stake 
or a kila, is called Kilah. The sort of presentation, in 
which the hands, feet and head of the child come 
out, with its body impacted at the entrance to the 
vagina, is called Prathikhurah. The type in which only 
a single hand and the head of the child come out 
(with the rest of its body obstructed at the same 
place), is called the Vijakah. The type in which the 
child remains obstructing the head of the passage in 
a horizontal position, like a bolt, is called the Parighah. 
Certain authorities aver that, these are the only four 
kinds of Mudhagarbha. But we can not subscribe to 
the opinion (which recognises only four kinds of false 
presentations), inasmuch as the deranged Vayu (Apana) 
can present the fsetus in various different postures 
at the head of the vaginal canal. Sometimes, the two 
thighs of the child are first presented, and sometimes it 
comes with a single leg flexed up. Sometimes the 
child comes with its body, bent double, and thighs 
drawn up, so that only breech is obliquely presented. 
Sometimes the child is presepted, impacted at the head 



Chap. VIII.] NIDANA STHANAM. 57 

of the passage with its chest, or sides, or back. Some- 
times the child is presented with its arm around its head, 
resting on the side, and the hand coming out first. 
Sometimes only the two hands are first presented, the 
head leaning on one side; sometimes the two hands, legs 
and the head of the child, the rest of the body being 
impacted at the exit in a doubled up posture. Some- 
times one leg is presented, the other thigh being impacted 
at the passage (Payu). I have briefly described these 
eight sorts of presentation of which the last two 
are irremediable. The rest should be given up as 
hopeless if these are attended with the following compli- 
cations viz., deranged sense-perception of the mother, 
convulsions, displacement or contraction of the repro- 
ductive organ (yoni) a peculiar pain like the after-pain of 
child birth, cough, difficult respiration, or vertigo. 4. 

lYIemorial verses :— As a fruit, fully matured, 
is naturally severed from its pedicel and falls to the 
ground and not otherwise, so the cord, which binds 
the foetus to its maternal part, is severed in course 
of time^ and the child comes out of the uterus ( into 
this world of action ). On the other hand, as a fruit, 
worm-eaten or shaken by the wind or a blow, untimely 
falls to the ground, so will a foetus be expelled out of its 
mother's womb, before its time. For four months 
after the date of fecundation, the faetus remains in a 
liquid state, and hence its destruction or coming 
out of the womb goes by the name of abortion. In the 
course of the fifth and sixth months the limbs of the foetus 
gain in firmness and density, and hence, its coming out 
at such a time is called miscarriage. 5-7. 

Prognosis ; — The enceinte who violently tosses 
her head in agony (at the time of parturition) and 
the surface of whose body becomes cold, compelling 



58 THE SUSHRUTA SAMHITA. [Chap. VIH. 

her to forego all natural modesty, and whose sides 
and abdomen are covered with nets of large blue- 
coloured veins, invariably dies with the dead child 
locked in her womb. The death of the foetus in the 
womb may be ascertained by the absence of movements 
of the foetus (in the womb) or of any pain of child-birth, 
by a brown or yellow complexion of the enceinta, cade- 
verous smell in her breath, and colic pain in the abdomen 
and its distension owing to the continuance of the swollen 
and decomposed child in the womb. 8-9. 

The death of a child in the womb may result from 
some emotional disturbance of its mother, (such as 
caused by bereavement or by loss of fortune during 
pregnancy) ; while an external blow or injury (to the 
womb) or any serious disease of the mother may also 
produce the like result. A child, moving in the womb 
of a dead mother, who had just expired (from convulsions 
etc.) during parturition at term, like a goat (Vastamara) 
should be removed immediately by the Surgeon from the 
womb (by Caesarean Section) ;* as a delay in extract- 
ing the child may leads to its death, io-:i. 

* Csecsarean Section means incision of the uterus through the abdomi- 
nal walls and extrication of the foetus therefrom. Operation like this upon 
a dead subject requires no skill of a surgeon. Any one can do it without 
the help of any anatomical knowledge. In modern times, when the 
mother's life is in peril, and the expulsion of the foetus becomes nearly 
impossible, by the natural passage, owing to an existenee of deformity 
either in the parturient canal or in the forms and structures of the foetus, 
to save both mother and child this operation is principally undertaken. 

The evidence of similar attempts, in ancient India, is found recorded 
in passages like what we have just translated and that the operation was 
practised on living subjects, there is not the least doubt about it. This 
custom is still preserved in Central Africa, and it is possible that the Egyp- 
tians like Hindu philosophy and religion learnt this also from the Hindus. 
"Felkin," says "Baas in his History of Medicine p. 70 "saw a case of the 
Csesarean operation in Central Africa performed by a man. At one stroke 



Chap. VlII.] NIDANA STHANAM. ^9 

Additional Text :— The bladder is ruptured, the dead child lies 
like a weight upon the placenta and is pressed upward on the spleen, liver 
and gall bladder. The mother shivers and is oppressed with tremor, 
dryness of the tongue, dyspnoea and perspiration. She complains of 
a cadaverous smell in her breath and stands in danger of imminent 
death. By these symptoms a physician shall know the death of the 
child in the womb. This portion is partly recognised by Brahmadeva 
and is totally rejected by Jejjadacharya as spurious. 

an incision was made through both the abdominal walls and the uterus. 
The opening in the latter organ was then enlarged, the hemorrhage 
checked by the actual cautery, and the child removed. While an assis- 
tant compressed the abdomen, the operator then removed the placenta. 
The bleeding from the abdominal walls was then checked. No sutures 
were placed on the walls of the uterus but the abdominal parietes were 
fastened together by seven figure-of-eight sutures, formed with polished 
iron needles and threads of bark. The wound was then dressed with a 
paste prepared from various roots, the woman placed quietly upon her 
abdomen, in order to favour perfect drainage, and the task of the African 
Spencer "Wells was finished. It appears that the patient was first rendered 
half unconscious with banana wine. One hour after the operation the 
patient was doing well. And her temperature never rose above loi F. 
nor her pulse above 108. On the eleventh day the wound was completely 
healed, and the woman apparently as well as usual." 

W^hen we read this evidence of Felkin, we are reminded of the opera- 
tive steps as described in our own ancient book of Surgery from which 
modern surgeons have been able to borrow the operation of rhinoplasty. 
It is a great pity that while in Africa the same practice is still retained 
intact, we in India by spurious attempts and disgraceful contortions, subs- 
titutions of false readings and dismal knowledge of grammar and rhetoric 
try to prove in the face of strong evidence that in ancient India Coesarean 
Section was attempted only on cases where one "might not perspire." 

If we take f%qfligi: in the sense of "a woman whose life is in great 
danger" and not exactly in the sense of "a woman who is dead" as recom- 
mended by Dalian and Arundutta (and which might have been the 
meaning if instead of ^^^f^ a word like o^iq^ had been used in the text), 
we find at once that Weber's remark in his History of Indian Literature 
p. 270 *'that in Surgery they (the Hindus) attained to high proficiency" 
is not based on the solitary evidence of rhinoplasty alone. 

In performing obstetric operations with success examples like this are 
not rare. If the two different readings 2f^?Ti'i; ^"^l ^f%^i^ be taken con- 
jointly into consideration we are impressed with the idea that in ancient 



6o THE SUSHRUTA SAMHITA. tChap. VIlI. 

India Csesarean operations were very frequently undertaken in cases of 
puerperal eclampsia, where the mother had been in the deplorable condi- 
tion of a goat suffering from cramps and convulsions as well as in cases 
of an accidental death not unlike that which fell to the lot of the poor 
mother of him in whose name the operation is called. ^g = goat aii?[ = 
destroyer (See Monier William's Dictionary) hence a goat-destroyer = a 
tiger or wolf) or in cases where the presence of deformity in the parturient 
canal or of malformation of the foetus prevented the natural delivery of a 
living child. The incision is not to be made anywhere else but exactly 
in the place where Felkin saw the illiterate Negro successfully apply his 
knife, the selection of ^f^' %\\,^ as suggested by some commentators 
being a tempest on a tea pot especially when the subject is beyond the 
grave. In a living subject the selection of a proper site for the operation 
is of course very commendable. Hence we venture to suggest that 
extraction of the living foetus from the womb by making incision through 
this part of the pelvis was also attempted later on. We extract here the 
two different readings and leave our readers to judge whether we are 
correct to draw the above inferences. — Ed. 

f^^TJ I Bdgabhata S'arira Sihanam. ch. II. slo. 53. 

Thus ends the eighth Chapter of the Nidana Sthanam in the Sus'ruta 
Samhita, which treats of Nidanam of difficult labour and false presenta- 
tions. 



CHAPTER IX. 

Now we shall discourse on the Niddnam of 
Vidradhi (abscess etc.)- I. 

The blessed Dhanvantari, the honoured of the gods, 
who for the promulgation of the knowledge of the 
Ayurveda and for administering proper medicines 
(to the sick), took his birth at Kdsi, (Benares) as a 
king, thus fully discoursed on the symptoms of Vidradhi 
(abscess etc.) to his disciple, Sus'ruta. 2. 

Definition and classification :— The 

extremely deranged and aggravated Vayu, Pittam 
and Kapham, resorting to the bone and vitiating 
the Tvaka ( skin ), blood, flesh, and fat of a person 
(with their own specific properties), gradually give 
rise to a deep-seated, painful, round or extended 
swelling which is called Vidradhi by the wise. The 
disease admits of being divided into six types such as 
the Vataja type, the Pittaja type, the Kaphaja type, 
the Sdnnipatika type, the Kshataja type (traumatic), 
and the Asrija (which has its seat in the vitiated blood). 
Now we shall describe their specific symptoms. 3-4. 

The Vataja Type : — This abscess assumes a 
black or vermilion colour, is felt rough to the touch and 
is characterised by a sort of excruciating pain. The 
growth and suppuration of the abscess are brought 
about in a variety of forms (owing to the variable 
and irregular action of the deranged Vayu inolved in 
these cases). 5. 

The Pittaja Type :— This abscess assumes a 
blackish yellow colour or one like that of a ripe Audum- 
vara fruit. It is attended with fever and a burning 
sensation, and is of rapid growth and suppuration. 6. 



62 NIDANA STHANAM. Chap. IX. ] 

The Kaphaja Type:— This abscess is shaped 
like an Indian saucer (s'arava) and seems cold to the 
touch. It assumes a light yellow colour and is character- 
ised by numbness, itching and little pain. The growth 
and suppuration of this abscess is very slow. The 
secretions from a Vataja abscess are thin, those from 
a Pittaja type are yellow, while the exudations from a 
Kaphaja abscess are white. J. 

The Sannipatika Type:— An abscess of 

the Sannipatika type is of varied colour, and is attended 
with a varied sort of pain (sucking, drawing, turning 
etc.) and exudes secretions of various colours (white, 
yellow, etc.). It is little raised or elevated at its top, 
large and irregular in its shape and does not uniformly 
suppurate in all its parts. 8. 

Agantuja or Kshataja Type :-~The local 

or inherent heat of an ulcer, (caused by a blow or a 
dirt) in a person, addicted to unwholesome regimen, is 
augmented and conducted by the deranged V^yu and 
vitiates the blood and Pittam, thus giving rise to a kind 
of abscess which is known as the Agantuja Vidradhi 
(traumatic abscess). Symptoms of the Pittaja type like- 
wise mark this type of abscess and fever, thirst and a 
burning sensation attend it from the very beginning. 9. 

The Raktaja Type:— This abscess assumes 
a black or tawny colour, covered with a large number 
of black vesicles, and fever and an intolerable burning 
and pain attended with all the symptoms peculiar tOj 
the Pittaja type, mark the present form of the disease. 
It is called Raktaja Vidradhi. Of external Vidradhis 
or abscesses, those of the Sannipatika type should be 
regarded as incurable. 10 — 11. 

Antara-Vidradhi :— Now we shall describe 
the characteristic features of internal abscesses (Antara- 



[Chap. IX. THE SUSHRUTA SAMHITA . 6$ 

VidradhI). The Vdyu, Pittam and Kaphah of the body, 
deranged through eating heavy, incompatible and in- 
congenial (to the physical temperament of the eater) 
articles of food or of dry, putrid and decomposed sub- 
stances, or by excessive coition and fatiguing physical 
exercise, or by voluntary repression of any natural 
urging of the body or through the eating of food which 
is followed by an acid reaction, either severally or 
collectively give rise to a tumour-like (Gulma), raised, 
or elevated abscess in the interior of the organism, which 
is often felt to be shaped like an ant-hill. 12-13. 

Localities : — They are generally found to be 
seated at the mouth (neck) of the bladder, or about the 
umbilicus, or in the sides, or in the Kukshi (inguinal 
regions), or on the Vrikkas, or on the liver, or in the 
heart, or on the Kloma, or on the spleen, or in the 
rectum. Their general characteristics are identical with 
those of the several types of external abscess. The 
symptoms of their suppurated or unsuppurated stages 
should be determined in the light of the chapter on 
Amapakvaishanyiam (Ch XVII Sutra.). 14-15. 

Their specific symptoms : -Now hear 

me describe the symptoms which specifically mark these 
internal abscesses according to their seats in the differ- 
j ent regions of the organism. An abscess appearing 
in the rectum (Guda) is marked by the suppression 
of the flatus ( Vata). Seated in the bladder, it gives rise 
to difficulty of urination and scantiness of urine. 
Appearing about the umbilicus it produces a distressing 
hic-cough and a rumbling sound (Atopa) in the intes- 
tines. Seated in either of the sides (Kukshi) it tends to 
aggravate inordinately the vayu of the body. Appear- 
ing in the inguinal region it gives rise to an extreme 
catching pain at the back and waiyt. Sea^ted in either 



64 NIDANA STHANAM [Chap. IX. 

of the Vrikkas it brings about a contraction of the sides. 
Appearing on the spleen, it produces symptoms of 
difficult and obstructed respiration. Seated on the heart 
it gives rise to an excruciating and piercing pain within 
its cavity and a drawing pain (Graha) extending all over 
the body (D. R. — cough). Seated in the Liver its 
characteristic indications are thirst and difficult 
breathing (D. R. — hic-cough) whereas a sort of unquen- 
chable thirst is the symptom which marks its seat on 
the Kloma. 16-17. 

Prognosis : — An abscess appearing on any 
vital part (Marma) of the organism, whether large 
or small in size, suppurated or unsuppurated, should be 
deemed as extremely hard to cure. Discharge from an 
abscess formed in the region of the organism above the 
umbilicus and (spontaneously bursting), will flow out 
through the mouth whereas similar secretions from down 
the umbilical region of (the abdomen), naturally find 
an outlet through the fissure of the anus. The case 
in which the secretions (pus etc.) find a down- 
ward channel and outlet may end in recovery of the 
patient; whereas the one in which the secretions take an 
upward course invariably proves fatal. An incision 
made by surgeon from the outside into an internal 
abscess, other than the one situated on the heart, or on 
the bladder or on the umbilicus may occasionally, prove 
successful, but the one, seated on any of the preceding 
vulnerable visceras (heart, bladder etc.) of the body and 
surgically opened invariably ends in death. 18-19. 

A woman, who has miscarried or has been even 
safely delivered of a child at term, may be afflicted with 
a dreadful abscess in the event of her taking injudi- 
cious and unhwholesome food after parturition. The" 
?ibscess in such a case, which is attended with extreme 



Chap. IX.] NIDANA STHANAM. 65 

hyper-pyrexia (Ddhajvara) should be considered as; 
having had its origin to the vitiated blood (Raktaja 
Vidradhi) accumuVated in , the organism. The abscess,, 
which appears in the Kukshi (in the iliac region) of 
a safely delivered woman owing to the presence of the 
unexpelled blood-clots in those regions after child- 
birth, should be also diagnosed as a case of Raktaja 
abscess. The unexpelled blood is called Makkalla* 
Such an abscess, if not absorbed in the course of a week, 
is sure to suppurate. 20 — 21. 

Differentiating diagnosis of Gulma 
and Vidradhi* :— Now I shall discuss the featuresi 

which distinguish a Gulma (internal tumour) from a 
Vidradhi (internal abscess). It may be asked, how is 
it that Gulma, (internal tumour) though caused by, 
and involving the co-operation of the same deranged 
Doshas as an internal abscess, does nut suppurate, while 
the latter (Vidradhi) does run to suppuration ? 22—23.. 
The answer is that a Gulma (internal tumour), though 
caused by the same deranged Doshas as a Vidradhi 
(internal abscess), does not resort to any deranged 
organic matter, such as flesh, blood, etc., while, on the 
contrary, in a case of Vidradhi, the diseased" flesh and 
blood of a locality are in themselves transformed into 
an abscess. An internal tumour (Gulma) is like a 
water bubble floating and moving about within a cavity 

* A Gulma according to Sus'ruta does not suppurate, but the term 
*'Api" (also) contemplates instances in which a Giil ma rinay suppurate 
as in the case where it has got its basis in the- deranged flesK eVcr' of the 
locality. Charaka asserts that retarded digestion" of the inges.ted -food 
followed by digestionary acid reaction, colic pain, insomnia with fever 
and a non- relish for food and a sense of oppcessiohi etc. ar« thei symp- 
toms which indicate that suppuration Has set in a Gulma, and be ' adVises 
that it (Gulma) should be treated^wixlrpouUices, etc. 



66 THE SUSHRUTA SAMHITA. [Chap. IX. 

of the body etc. without any fixed root of its own. 
Hence, it is that a Gulma (internal tumour) does not 
suppurate at all. Suppuration sets in in an abscess only 
because it largely contains flesh and blood unlike a 
Gulma (internal tumour) which is not formed of any 
such organic matter, and depends only on the aggravated 
Doshas giving birth to it. Hence, a Gulma does not 
suppurate at all. 24. 

Incurable Types :— A case of an internal 
abscess suppurating about the heart, bladder or 
umbilicus as well as one of the Tridosha type (appearing 
in any part of the organism) should be given up as in- 
curable. The abscess in which the marrow suppurates 
(generally) becomes fatal. The suppurating process in 
an internal abscess, which generally affects the under- 
lying bone, is sometimes found to affect the marrow. 
The suppurated marrow, failing to find an outlet on 
account of the compactness of the local flesh and bone, 
produces a sort of burning sensation in the localit}^ 
which consumes the body like a blazing fire. The 
disease confined to the bone, like a piercing dirt, 
torments the patient for a considerable length of time. 
An incision (made into the affected bone) is followed 
by the secretion of a fat-like, glossy, white, cold and 
thick pus. Men, learned in the knowledge of the 
Medicinal Sastras, designate such an abscess as an 
Asthighata-Vidradhi (abscess of the bone) which 
involves all the three kinds of deranged Doshas, and is 
attended with various kinds of pain which mark them 
respectively. 25-26. 

Thus ends the ninth Chapter of the Nidanasthanam in the Sui'rut^ 
3f^nbitd which treats of the setiology of abscess. 



CHAPTER X. 

Now we shall discourse on the Nidanam of Visar- 
pa (erysipelas), Nad! (sinus) and Stana-roga 

(diseases affecting the mammae of a woman), i. 

Definition of Visarpa :~The deranged and 
aggravated Doshas, (Vayu, Pittam and Kapham) having 
recourse to, and affecting the Tvaka (Skin), flesh and 
blood, speedily give rise to a sort of shifting, elevated 
swelling (Sotha) marked by the characteristic symptoms 
of any of them involved in the case. This swelling tends 
to extend all over the body. The disease is called 
Visarpa from the fact of its extending or swiftly shifting 
character (Skr. srip -to go, to extend). 2. 

The Vataja Type :— The swelling (Sotha) is 
soft and rough and assumes a black colour attended with 
an aching pain in the limbs and a cutting or piercing 
pain (in the affected locality). It is further marked by 
(all the usual) symptoms of the Vdtika fever. A case of 
this type in which uneven flame coloured vesicles or 
bulbs appear on the affected part through the extreme 
vitiation (of the Vayu and Pittam) should be given up 
as incurable. 3. 

The Pittaja and Kaphaja Types :-Thc 

Pittaja Visarpa (erysipelas) rapidly extends (over the 
body), attended with severe fever, a burning sensation, 
suppuration and cracking (of the skin;. A large 
number of vesicles appears on the spot which as- 
sume a blood-red colour. A case of this type, 
characterised by the destruction of the local flesh and 
veins owing to the excessively aggravated condition of 
the deranged Doshas (Kaphha and Pittam) and a 



68 THE SUSHRUTA SAMHITA. [Chap. X. 

collyrium-Iike black colour (of the swelling), should be 
regarded as incurable. The Kaphaja Visarpa extends 
slowly and the process of suppuration is tardy. The 
affected part becomes white, glossy and swollen, and 
is marked by a slight pain and excessive itching. 4-5. 

The Sannipatika Type : -The Visarpa of 

the Tridoshaja type is deep-seated and the affected 
part assumes all colours and is attended with all sorts 
of pain which are peculiar to the three aforesaid types. 
The local flesh and veins are destroyed in the suppurating 
stage of this disease and hence, it shouldbe looked 
upon as incurable. 6. 

The Kshataja Type (Erysipelas due to a 
wound or an ulcer):— The Pittam of a person with a 
temperament marked by the extreme aggravation of all 
the three Doshas, in conjunction with the blood, resorts 
to a wound* in his body and immediately gives rise to 
Eiysipelas (Sopha— lit rash) which assumes a reddi.sh- 
brown colour, with high fever with a burning sensation, 
and suppuration in its train, and it is found to be 
covered with black vesicles to the size of Kulattha 
pulse. 7. 

Prognosis : — The Vataja, Pittaja and Kaphaja 
Visarpas are curable ; the Sannipdtika and Khataja 
ones being incurable. The symptoms, which indicate 
an unfavourable prognosis in a case of Vdtaja or 
Pittaja Erysipelas, have been described before. Those, 
which attack the vital parts (Marmas) of the body, can 
be cured only with the greatest difficulty.i* 8. 

* Or through the extreme augmentafion of all the three doshas in 
the ulcer (Sadyah-kshata-Vj ana) according to others. 

t Golden coloured (yellow) Erysipelas due to the action of the 
(deranged) Pittam is incurable (AV/a/wa /^h-tichana-vapuicha ta^hi na 
sydhyet.).''V>. R. 



Chap. X.] , NIDANA STHANAM. 69 

The N^ldi-Vrana :~The pus of an abscess or 
swelling burrows into the affected part if a person 
neglects it in its fully suppurated stage, dubious of its 
being so conditioned, or not, or even neglects to open a 
fully suppurated abscess. An abscess or swelling is 
called a Gati Vrana owing to an excessive infiltration 
of pus, and it is also called a N^di-vrana owing to the 
presence of a large number of recesses or cavil ies in 
its inside. There are five different types of Nddi-vrana 
(sinuses) such as the Vdtaja, Fittaja, Kaphaja, Tridoshaja 
and Salyaja. 9— 10. 

The Vataja, Kaphaja and Pittaja 

Types :~The V^fcaja SiEUS is rough and short- 
mouthed, characterised by an aching pain (in its inside). 
It exudes a sort of frothy secretion which becomes 
greater at night and is attended with an aching pain. 
Thirst, lassitude, heat and a piercing pain jn the affected 
locality) are the usual accompaniments of the Pittaja 
types. Fever is present from the beginning and the Sinus 
exudes a large quantity of hot and yellow coloured 
secretion which is more by day than by night. The 
Kaphaja Sinus becomes hard and is characterised by 
'itching and a slight pain (numbed ?). It is found to 
secrete a copious quantity of thick, shiny, white-coloured 
pus which becomes greater at night. 11-13. 

Dvandaja and Tridoshaja Types :— 

A case of Nddi-Vrana involving the concerted action 
•of any two of the deranged Doshas (Vayu, Pittam 

and Kapham) and exhibiting symptoms peculiar to 
• both, is called a Dvandaja* one. There are three 



* Gayadasa does not read the symptoms of Dvi-doshaja (?.<;., due 
to two morbific principles) types of sinus a g ven in the text which 
he has rejected as spurious 



70 THE SUSHRUTA SAMHITA^ [Chap. X. 

types of this class of disease, (such as the Vata-pittaja, 
Vhta-kaphaja and Pitta-kaphaja) A case of Na'di- 
vrana, exhibiting symptoms of the three aforesaid types, 
and attended with fever and a burning sensation, diffi- 
cult breathing, dryness of the mouth and syncope, is 
called Tridoshaja. An attack of this type should 
be regarded as dreadful and fatal, casting around the 
gloom of death. I4-I5- 

The ^alyaja Nadi-Vrana :— A foreign 

matter (such as dirt, bone, splinter etc.), lodged within 
the body and invisible to the eye, tends to burst open 
the skin, etc. of the locality along its channel of inser- 
tion and gives rise to a type of Sinus. It is character- 
ised by a constant pain, and suddenly and rapidly 
exudes a sort of hot, blood-tinged, agitated, frothy secre- 
tion. This type is called Salyaja. i6. 

ThcStana-Roga: — These may be divided into 
as many types as the aforesaid Nadi-Vrana and are 
caused by the same exciting factors as the last named 
malady. The milk-carrying ducts remain closed in the 
breast of a nullipera thus barring the possibility of the 
descent of the Doshas through them and of an attack 
of any disease at that part of the body. On the 
contrary, such ducts in the breast of a piimipara open 
and expand of their own accord, thus making the 
advent of diseases possible that are peculiar to the 
mamma. I7-I9- 

The breast-milk : -The sweet essence of the 
Rasa (lymph chyle) drawn from the digested food 
courses through the whole body and is ultimately con- 
centrated in the breast of a mother or a woman (big 
with child) which is called milk. 2o. 

Its character :— The breast-milk, like semen, 
lies hidden and invisible in the organism, though 



Chap. X ] NIDANA STHANAM. /r 

permeating it in a subtle or essential form. The charac- 
teristic features of the breast-milk bear analogy to those 
of semen The breast milk is secreted, and flows 
out at the touch, sight or thought of the child in the 
same manner as the semen is dislodged and emitted 
at the sight, touch or recollection etc. of a beloved 
woman. As the strong and unclouded affections of a 
man are the cause of the emission of semen, so the fondest 
love of a mother for her children brings about the secre- 
tion of her breast-milk Both semen and breast-milk are 
the product of the essence of digested food, this essence 
being converted into milk in women. 21 — 22. 

Its abnormal and normal Traits: — 

The milk of a mother vitiated by the deranged Vayu 
of her system has an astringent taste and floats on 
water The milk of a mother vitiated by the deranged 
Pittam has an acid and pungent taste and becomes 
marked with a yellow hue,* if left to float on water. The 
milk of a mother vitiated by the deranged Kapham 
is thick and slimy and sinks in water. The milk of a 
mother vitiated by the concerted and simultaneous 
derangement of the three Doshas of the body is marked 
by the combination of all the preceding symptoms. An 
external blow or hurt too (Abhighata) sometimes pro- 
duces vitiation of the mother's milk. 23. 

The milk (of a mother), which instantly mixes with 
water, tastes sweet and retains its natural greyish tint, 

should be regarded as pure. 24. 

The bodily Do.shas having recourse to the breasts of 

a woman whether filled with milk or not and vitiatinsf 

o 

the local flesh and blood give rise to mammary diseases, 

* The particle 'Cha" in the text indicates that the colour may turn 
blue or pink in some cases. 



72 THE SUSHRUTA SAMHITA. [Chap. X. 

(Stana-roga). All the types of abscess (Vidradhi) 
excepting the one called the Raktaja out of the six 
types desciibed before are found to attack the mammae^ 
and their symptoms should be understood as identical 
with those of external abscesses. 25. 

Thus ends the tenth Chapter of the Nidaram Sthdnam in the Su&'ruta 
Samhit^ w ich treats of the oetiolcgy and symptoms of Erysipelas, vSinus 
and mammary abscesses. 



CHAPTER XL 

Now we shall discourse on the Nid^nam of Granthi 
(Glands etc.), Apachi (Scrofula etc.), Arvudi (Tumours) 
and Gralagand a (Goitre), i. 

The deranged and unusually aggravated Vayu etc. 
(Pittam and Kapham), by vitiating the flesh, blood and 
fat mixed with the Kapham (of any part of the or- 
ganism), give rise to the formation of round, knotty, 
elevated swellings which are called Granthi (Glandular 
inflammation). 2. 

The Dosha-Origined Types :— The swell- 
ing (Sopha) of the Vaitatja type seems as if it were 
drawn into and elevated or as if severed or pricked 
with a needle, cleft in two or drawn asunder or as if 
cut in two or pierced. The knotty growth assumes a 
black colour, and is rough and elongated like a bladder. 
On bursting a granthi of this type exudes clear bright 
red blood. The Fittaja Granthi is characterised by 
heat and an excessive burning sensation (in its inside). 
A pain, like that of being boiled by an alkali or by 
fire, is felt in the inside. The knotty formation assumes 
a red or yellowish colour and exudes a flow of extremely 
hot blood on bursting. The Kaphaja Granthi is slightly 
discoloured and cold to the touch. It is characterised 
by a slight pain and excessive itching, and feels hard 
and compact as a stone. It is slow or tardy in its 
growth and exudes a secretion of thick white-coloured 
pus when it bursts. 3-5. 

The Medaja Type :— The fat origined Gran- 
thi is large and glossy and gains or loses in size with 
the gain or loss of flesh by the patient. It is marked 

10 



74 THE SUSHRUTA SAMHItA. [Chap. Xt. 

by a little pain and an excessive itching sensation and 
exudes a secretion of fat resembling clarified butter or 
a gruel, in colour and consistency, made of the levigated 
paste of sesamum on bursting. 6. 

Si ra-Granthi— (aneurism or varicose veins) : — 
The bodily Vayu in weak and enfeebled persons, de- 
ranged by over-fatiguing physical exercises, straining or 
exertion or by pressure, presses on, contracts, dries or 
draws up the ramifications of veins (Sira) or arteries 
(of the affected locality), and speedily gives rise to a 
raised knotty formation which is called a Sira-Granthi, 
In the event of its being shifting and slightly painful, 
it can be cured only with the greatest difficulty. 
Whereas a case in which the knotty formation is pain- 
less, fixed, large and situated at any of the vital parts of 
the body (Marmas), should be deemed incurable.* 7. 

Apachi — (Scrofula etc.) : — The augmented and 
accumulated fat and Kapham give rise to string of hard 
glossy, painless, nodular, or elongated granthi (swellings) 
about the joints of the jawbones, at the waist, joint, 
about the tendons of the neck, about the throat or about 
the region of the arm-pits. These glands (Granthis) re- 
sembling the stones of the Amalaka fruit or the spawn 
of fish in shape or like some other shape, are of the same 
colour as the surrounding skin ; and a string or a large 
crop of such glandular knots, gradually growing is 
called Apachi-f- on account of the extensive nature of 
their growth. 8-9. 

* In several editions an additional line is to be found running as men 
well conversant with symptoms (of Gtanthis) recognise a type of Granthi 
due to the action of the deranged flesh and blood, which exhibits symp- 
toms identical with those of a tumour {Mansjtasrayam chdrvuda 
laskhanena tulyam hi drish/awaih lakshanajunih). But Jejjata has 
rejected it as of questionable authority. 

t These glandular formations appear about the root of the penis, about 
the sides, in the arm-pits and about the throat and the tendons of the neck. 



Chap. XI.] NIDANA STHANAM. 75 

These knotty formations are characterised by itching 
and a slight pain. Some of them spontaneously burst 
exuding secretions while others are observed to vanish 
and re-appear (in succession). Such vanishings, re- 
appearances, or fresh formations continue for a consider- 
able time. The disease undoubtedly owes its origin to 
the deranged fat and Kapham, and may only be made 
amenable (to medicine) with the greatest difficulty 
lasting for years at a time. lO. 

ArVUda— (tumour etc.) : — The large vegetation 
of flesh which appears at any part of the body, becomes 
slightly painful, rounded, immovable and deep-seated, 
and has its root sunk considerably deep in the affected 
part, and which is due to the vitiation of the flesh 
and blood by the deranged and aggravated Doshas 
(Vayu, Pittam and Kapham) is called an Arvuda 
(tumour) by the learned physicians*. The growth of 
an Arvuda is often found to be slow, and it seldom 
suppurates. The characteristic symptoms of an Arvuda 
which owes its origin to the deranged condition of the 
Vayu, Pittam, Kapham, flesh or fat, are respectively 
identical with those, which mark the cases of Granthis, 
brought about by the same deranged principles of the 
body. II. 

Raktaja— Arvuda :— The deranged Doshas 
(Vayu, Pittam and Kaphami) contracting, compressing 



They resemble spawns of fish in shape and size and are due (o the action 
of the deranged Vayu, Pitiam and Kapham. The appearance ol such 
glands in the upper part of the body should be attributed to the aciicn 
of the deranged and aggravated Vayu. They are ixtremdy hard to cure 
inasmuch as their growth (formation) involves the concerted action 
of the morbific principles (Doshas) of the body. — Bhoja. 

Charaka, who designates this disease as Gandatncild, describes its 
location in regions about the jawbones alone. 

* That they having recourse lo the flesh, produce deep-seated 
vegetations (of flesh) is the reading adopted by Gayadasa and ot>iers. 



76 THE SUSHRUTA SAM HIT A. [Chap. XI. 

and drawing the vessels (Sira) and blood (of the affec- 
ted partj, raise a slightly suppurated and exuding 
tumour which is covered with small warts and fleshy 
tubercles and is called a Raiktatrvuda. This tumour is 
rapid in its growth and exudes a constant flow of 
(vitiated) blood. The complexion of the patient owing 
to depletive actions and other concomitant evils of 
haemorrhage becomes pale and yellow. The type 
should be considered incurable on account of its having 
its origin in the blood.* 12 — 13. 

IVIansarvuda :— The flesh of any part of the 
body hurt by an external blow etc. (hurting it with a 
log of wood — D.R.) and vitiated in consequence, gives 
rise to a sort of swelling (tumour) which is called 
Mdnsarvuda, which originates through the action of 
the deranged Vdyu. It is glossy, painless, non-sup- 
purating, hard as a stone, immobile, and of the same 
colour as the surrounding skin. Such a tumour 
appearing in a person addicted to meat diet becomes 
deep seated owing to the consequent vitiation of the 
bodily flesh and soon lapses into one of an incurable 
type. 14. 

ProgTIOSIS :— Even of the aforesaid curable 
types (such as the Vataja, etc.^, the following types of 
Arvudam (tumours) should be likewise regarded as incur- 
able, those which appear in the cavity of a Srota chan- 
nel or an artery , or any vulnerable joint of the body and 
arc characterised by any sort of secretion and also im- 
movable, should be deemed incurable. An Arvudam 
(tumour) cropping up on one existing from before is 



* Although all types of Arvuda have their origin in the deranged flesh 
and blood, i)reponderant action of the deranged blood is found in Raktd- 
arvuda^ while a dominant action of the deranged flesh marks the 
MAmArvuda type. 



Chap. XI. NIDANA STIIANAM. TJ 

called Adhyarvudam, which should be likewise deemed 
as incurable. A couple of contiguous Arvudam (tumours) 
cropping up simultaneously or one after another is called 
Dviarvudam, which should be held as equally incurable 
(with one of the foregoing types). An Arvuda (tumour) 
of whatsoever type, never suppurates owing to the 
exuberance of the deranged Kapham and fat as well 
as in consequence of the immobility, condensation and 
compactness of the deranged Doshas (Vayu, Pittam and 
Kapham involved in the case, or out of a specific trait 
of its own nature. 15-16. 

Definition of Galaganda (Goitre;:— The 

deranged and aggravated Vayu in combination with the 
deranged and augmented Kapham and fat of the loca- 
lity affects the two tendons of tne neck (Manyds) and 
gradually gives rise to a swelling about that part of the 
neck characterised by the specific symptoms of the 
deranged Doshas (Vayu or Kapham) and principles in- 
volved in the case. The swelling is called Galganda 
(Goitre). 17. 

Symptoms of the Dosha-orig-ined 

Types : — The swelling or tumour in the Va^tajai goitre 
is characterised by a pricking pain (in its inside) marked 
by the appearance of blue or dark coloured veins Sira) 
on its surface. It assumes a vermilion or tawny brown 
hue. The goitre becomes united with the local fat 
in course of time, and gains in size, giving rise to a 
sense of burning in the throat, or is characterised by 
the absence of any pain at all. A Vataja goitre is rough 
to the touch, slow in its growth, and never or but rarely 
suppurates. A sense of dryness in the throat and the 
palate as well as a bad taste in the mouth likewise 
marks this type. The swelling in the Kaphaja Type 
assumes a large shape and becomes hard, firm, cold 



78 THE SUSHRUTA SAMHITA. [Chap. XI. 

and of the same colour (white). There is but slight pain 
and the patient feels an irresistible inclination to scratch 
the part. It is slow in its progress and suppuration is 
rare and tardy. A sweet taste is felt in the mouth and 
the throat and the palate seem as if smeared with a sort 
of sticky mucous. 18-20. 

Symptoms of the IVledaja Type:— 

The swelling is glossy, soft (heavy — D.R) and pale- 
coloured. It emits a fetid smell and is characterised by 
excessive itching and an absence of pain. It is short at 
its root and hangs down from the neck in the shape of a 
pumpkin (Aldvu), gradually gaining its full rotundity at 
the top. The size of the goitre is proportionate to the 
growth or loss of flesh of the body. The face of the 
patient looks as if it has been anointed with oil and a 
peculiar rumbling sound is constantly heard in the 
throat. 21. 

Prognosis : - A case of goitre attended with 
difficult respiration, a softening of the whole body, 
weakness, a nonrelish for food, loss of voice as well as 
the one which is more than of a year's standing should 
be abandoned by the physician as incurable. 22. 

Metrical Text: — A pendent swelling whether 
large or small and occurring about the region of the 
throat and resembling the scrotum in shape is called 
a Gala-Ganda. 23. 

Thus ends the eleventh Chapter of the Niddna Sthanam in the 
Susruta Samhita which treats of the Nidanam of Granlhi, Scrofula, «lc. 



CHAPTER XII 

Now we shall discourse on the Nidanamof Vriddhi 
(hydrocele, hernia, scrotal tumours etc), Upaclansa 
(disease of the genital organ*, and Slipada (ele- 
phantiasis), I . 

Classes : -There are seven different types of 
Vriddhi such as the Vataja, Pittaja, Kaphaja, Raktaja, 
Medaja, Mutraja and the Antra-vriddhi. Of these both 
the Mutraja-vriddhi (hydrocele or extravagation of the 
urine), and Antra-vriddhi types, though owing their ori- 
gin to the deranged condition of the bodily Vayu, have 
been so named after the organic matters or anatomical 
parts (urine, iliac colon etc.) involved in them. 2. 

Definition and Premonitory symp- 
toms : — Any of the deranged Doshas (Vayu, Pittam, 
etc ) lying in the nether regions of the body may resort 
to the spermatic cords (Dhamani) and give rise to a 
swelling and inflammation of Phalacosha (scrotal sac) 
which is called Vriddhi (scrotal tumour etc.). A pain 
in the bladder, scrotum, penis and the waist (Kati) 
incarceration of the Vayu and the swelling of the 
scrotum, are the premonitory symptoms of the 
disease. 3 — 4. 

The Dosha-origined Types :— The type 

in which the scrotum becomes distended with Vayu 
like an inflated air-drum, marked by roughness of 
(its surface) and the presence of a varied sort of Vataja 
pain (in its interior) without any apparent cause is called 
Vataja Vriddhi. The swollen scrotum, of the 
Pittaja Vriddhi, assumes the colour of a ripe 



8o THE SUSHRUTA SAMHITA. [Chap. XII. 

Audumvara fruit and is attended with fever, a burning 
sensation and heat in the affected part. It is of a 
marked rapid growth and speedy suppuration (of the 
scrotum). The swollen organ in the Kaphaja Vriddhi 
becomes hard and cold to the touch accompanied by- 
little pain, and itching (in the affected part . In the 
Raktaja type the swollen scrotum is covered over with 
black vesicles, all other symptoms of the type being 
identical with those of the Pittaja one. In the Medaja 
type the swollen scrotum looks like a ripe TMa fruit 
and becomes soft, glossy and slightly painful. The 
patient feels a constant inclination to scratch the part. 
The Mutraj a- vriddhi (hydrocele) owes its origin to 
a habit of voluntary retention of urine, its characteristic 
symptoms being softness and fluctuation on the surface 
of the swollen scrotum like a skin-bladder filled with 
water, painful urination, pain in the testes and swelling 
of the scrotum. 5. 

Antra-vriddhi (Inguinal hernia) :— The local 
Vayu enraged and unusually aggravated by lifting a 
great load, wrestling with a stronger person, violent 
physical strain or a fall from a tree and such like 
physical labour doubles up a part of the small intestine 
and presses it down into the inguinal regions lying 
there strangulated in the form of a knot (Granthi) 
which is known as Antra-vriddhi (inguinal hernia). 
The part not properly attended to at the outset 
descends into the scrotum which becomes ultimately 
elongated and intensely swollen and looks like an 
inflated air-bladder. It (hernia) ascends upwards under 
pressure, making a peculiar sound, (gurgling) ; while let 
free it comes down and again gives rise to the swelling 
of the scrotum. This disease is called Antra-vriddhi 
and is incurable. 6. 



Chap. XII.] NIDANA STHANAM. 8l 

TheUpadansam:— An inflammatory swelling 
of the genital, whether ulcerated or not is called 
TJpadansa*. The disease owes its origin to the 
action of the local Doshas, aggravated by promiscuous 
and excessive sexual intercourse, or by entire absti- 
nence in sexual matter ; or by visiting a woman, who 
had observed a vow of lifelong continence or one who has 
not long known a man, or one in her menses or one with 
an extremely narrow or spacious vulva, or with rough or 
harsh or large pubic hairs ; or by going unto a woman 
whose partturient canal is studded with hairs along its 
entire length ; or by visiting a woman not amorously 
disposed towards the visitor and vice versa ; or by know- 
ing a woman who washes her private parts with foul 
water or neglects the cleanliness of those parts, or suffers 
from any of the vaginal diseases, or one whose vagina 
is naturally foul ; or by going unto a woman in any of 
the natural fissures of her body other than the organ of 
copulation (Vi-yoni) ; or by pricking the genital with 
finger nails, or biting it with the teeth, or through poison- 
ous contact, or through practice of getting the (penis 
abnormally elongated by pricking the) bristles of a 
water parasite {Suka) into its body ; or by practising 

* Upadans'a is not syphilis whole to whole. Certain types of 
Upadans'a such as the Raktaja and Sannipatika types which entail the 
destruction of the organs concerned exhibit certain symptoms which are 
common to syphilis as well. The secondary eruptions and tertiary 
symptoms of syphilis are not mentioned by ihe A'yurvedic Rishis who 
used to treat it only with vegetable medicines and this fact intimates 
the probability that the secondary and tertiary symptoms of syphilis 
might not arise by their efficient and able treatment from the very 
beginning, preventing the absorption of the poison into the system. 
The practice of ablution, so common among the Hindus, might be 
taken into consideration as one of the important preventive factors. 
Maharshi Cbaraka has comprised it within the chapter on 'Senile 
Impotency'.— Ed, 



g2 THE SUSHRUTA SAMHITA. [Chap. XII. 

masturbation, or any unnatural offence with female 
quadrupeds ; or by washing the genitals with filthy or 
poisonous water ; or through neglect to wash the parts 
after coition, or voluntary suppression of a natural flow 
of semen or urine or through any hurt or pressure 
on the organ etc. The inflammation of the genital 
thus engendered is called Upadans'a. The disease 
admits of being divided into five distinct types, such 
as, the Vitaja, Pittaja, Kaphaja, Tridoshaja and the 
Raktaja. 7—8. 

The symptoms of different Types:— 

The roughness of the genitals, the bursting or cracking 
of the integuments of the penis and prepuce etc., numb- 
ness and swelling of the aff'ected part which is perceived 
rough to the touch and the presence of a varied sort of 
pain peculiar to the deranged Vayu are the characteristic 
indications of the Vattaja type. In the Pittaja type 
fever sets in (from the very beginning), the penis becomes 
swollen and assumes the colour of a ripe Indian fig 
(reddish-yellow), attended with a sort of intolerable 
burning sensation. The process of suppuration is rapid 
and a variety of pain peculiar to the deranged Pittam, 
(distinguishes it from the other forms of the disease). 
The penis becomes swollen, hard and glossy in the 
Kaphaja type marked by itching and a variety of 
pain characteristic of the deranged Kapham. In the 
blood-origined type (Raktaja) the organ bleeds heavily 
and is covered with the eruptions of large black vesicles. 
Fever, thirst, (Sosha), burning sensations and other 
characteristic symptoms of the deranged Pittam are also 
present. Palliation is all that can be occasionally effected 
in these cases. Symptoms specifically betraying to each 
of the Vataja, Pittaja and Kaphaja types concurrently 
manifest themselves in the Satnnipaitika type of Upa- 



Chap. XII.] NIDANA STHANAM. 83 

dansa. The organ cracks, the ulcers or cancers become 
infested with parasites and death comes in to put a stop 
to the suffering of its wretched victim. 9—13. 

^lipadam (Elephantiasis) :- The disease in which 
the deranged Vayu, Pittam and Kapham, taking a down- 
ward course, are lodged in the thighs, knee-joints, legs 
and the inguinal regions and spread to the feet in course 
of time and gradually give rise to a swelling therein, 
is called Siipadam. There are three types of Slipada 
severally due to the actions of the deranged Vayu, 
Pittam and Kapham. 14— 15. 

The symptoms of the different 

Types! — The swollen parts assume a black colour in 
the VsLfcaja type and are felt rough and uneven to the 
touch. A sort of spasmodic pain without any apparent 
reason is felt (at intervals in the seat of the disease), 
which largely begins to crack or burst. The Pittaja 
type is characterised by a little softness and yellowish 
hue (of the diseased localities) and often attended with 
fever, and a burning sensation. In the Kaphaja type the 
affected localities become white, glossy, slightly painful, 
heavy, contain large nodules (Granthis) and are studded 
over with crops of papillae. 16. 

Prognosis : — A case of elephantiasis of a year's 
growth as well as the one which is characterised by 
excessive swelling (of the affected parts), exudation and 
vegetation of knotty excrescences resembling the sum- 
mits of an ant-hill should be given up as incur- 
able. 17. 

Memorable Verses : -A preponderance of 

the deranged Kapham marks the three types of the 
disease, in as much as, the heaviness and largeness (of 
the swelling) can not be brought about by any other 
factor than Kapham. The disease is peculiar to countries 



84 THE SUSHRUTA SAMHITA. [Chap. XII. 

in which large quantities of old rain-water remain 
stagnant during the greater part (lit.- all seasons) 
of the year making them damp and humid in all 
seasons. 18-91 

The disease is usually found to be confined to the legs 
and hands of men but cases are on record in which it 
has extended to the ear, nose, lips and the regions of the 
eyes. (Penis — Mddhaba-Niddnam). 20. 

Thus ends the twelfth Chapter of ihe Nidanasthanam in the Sus'ruta 
Samhifa which treats of the Nidanara of scrotal tumours, hernia, Upa- 
dans'am and elephantiasis. 



CHAPTER Xm. 

Now we shall discourse on the Nidanam of 
Kshudrarog'am (diseases which are known by 
the general name of minor ailments), i. 

These diseases are generally divided into forty- 
four distinct varieties or types such as : — Ajagallikji, 
Yavaprakshya, Andhdlaji, Vivrit^, Kachchapika, 
Valmika, Indravriddhd, Panasikd, Pashdna-garddabha, 
Jala-garddabha, Kakshd, Vishphota, Agni-rohini, 
Chippam, Kunakha, Anusaye, Viddrikd, Sarkard- 
Arbudam, Pam^, Vicharchikd, Rakasa, Pddadarikd, 
Kadara, Alasa, Indralupta, Darunaka, Arunshika, 
Palitam, Mas'urika, Yauvana-pidaka, Padmini-kantaka, 
Yatumani, Mas'aka, Charmakila,Tilakdlaka, Nyachchya, 
Vyanga, Parivartiki, Avapatikd, Niruddha-prakas'a, 
Niruddha-guda, Ahiputanam, Vrishana-kachchu, and 
Guda-bhrans'a . * 2. 

Metrical Texts : — The species of pimples or 
eruptions which are shaped like the Mud^a pulse and 
are glossy, knotty and painless is called Ajagallikai. 
They are of the same colour (as the surrounding 
skin) and their origin is usually ascribed to the action 
of the deranged Kapham and Vayu. The disease is 
peculiar to infants.f Ya^vaiprakshyai :— The eruptions 

* Brahmadeva comprising Garddavika^ Irvellika, Gandhapidikd and 
Tilakdlaka in the list reads it as consisting of thirty-four different species. 
Jejjata does not hold the four forms of disease commencing with Gardda- 
vika, etc, as inchided within the list. Gaydd^sa, finding them included in 
all the recensions reads Garddabhikd, etc. as included within -the list of 
Kshudra Roga, and Pama etc. as included within the list of Kshudra 
Kushtham. 

t They afflict certain infants— Dallana. 



86 THE SUSHRUTA SAMHITA. CCh»p. XIII. 

which are shaped like the barley-corns, extremely hard, 
thick at the middle, knotty and affect (lit— confined to) 
the flesh are called Yavaprakshya. They are due to the 
action of the deranged Vayu and Kapham. Andhail ji : 
— The dense, raised, slender-topped eruptions which 
appear in circular patches and exude a slight pus 
are called Andhdlaji. They are due to the action of 
the deranged Vdyu and Kapham. VivritSfc: — Pustules 
or eruptions, which are coloured like a ripe fig. fruit and 
are flat-topped and appear in circular patches with an 
intolerable burning sensation, are called Vivrita They 
are due to the action of the deranged Pittam. 3 - 6. 

Kachchapika :— A group of five or six hard, 
elevated, nodular eruptions (Granthis), arranged in the 
shape of a tortoise (which may appear on the sur- 
face of any part of the body), are called Kachchapikd. 
They are due to the action of the deranged Kapham 
and V4yu. Valmika : —The knotty undurated erup- 
tions (Granthis) which gradually appear on the soles, 
palms, joints, neck and on the regions above clavicles 
and resemble an ant-hill in shape, slowly gaining in size 
are called Valmika Ulcers attended with pricking 
pain, burning, itching sensations and exuding mucopu- 
rulent discharges appear around the aforesaid eruptions 
(Granthis). The disease is due to the action of the 
deranged Kapham, Pittam and Viyu. 7 — 8. 

Indravriddhst : -Pimples or eruptions ^Pidakd) 
arising (on the surface of the body), arranged in the same 
circular array as marks the distribution of the seed (sacks) 
in a lotus flower are called Indravriddha' by the 
physicians. The disease is caused by the action of the 
deranged Vdyu and Pittam. Pauasika : — Eruptions 
(Pidakd) of a sort of extremely painful pustules all 
over the back or the ears which resemble the 



Chap. XIII.] NIDANA STHANAM. 87 

Kumuda bulb in shape, are called Panasikat. They 
are due to the action of the deranged Kapham and 
Wkyu. i: a^sha^na-Garddabha :— A slightly painful and 
non-shifting hard swelling, which appears on the joint 
of the jawbones, (Hanu-sandhi, is called Pashdna- 
Garddabha. The disease is the effect of the deranged 
Kapham and Vdyu. Jaila-Garddabha : — A thin and 
superficial swelling, which like erysipelas is of a 
shifting or progressive character and is further attended 
with fever and a burning sensation and which is but 
rarely found to suppurate, is called Jdla-Garddabha* 
The disease results from the deranged Pittam. 
Kakshai • — The disease characterised by the eruptions of 
black and painful vesicles i^ShphotaJ on the back, sides, 
and on the region about the arm-pits, is called Kaksha. 
The disease is likewise attributed to the action of the 
aggravated Pittam, Vishphotaka — The disease in 
which eruptions of burnlike vesicles (Shphota) crop up 
on the whole surface of the body, or on that of any 
particular locality, attended with fever, is called Vish- 
photaka. The disease is the effect of vitiated blood 
and Pittam. 9 — 14. 

Agni-Rohinif ;— Vesicles (Shphota) having the 
appearance of burns and cropping up about the waist 

* The circular raised spots studded with vesicles are called Gardda- 
bhil. They are reddish and painful and produced by the action of Vayu 
and Pittam. Gayadasa reads it so. 

t Dallana quotes from another Tantram that the morbific principles 
in men, aggravated through the action of the enraged and augmented 
Pittam and blood, give rise to vesicles (blisters) like red-hot charcoal by 
breaking open the flesh at the waist, attended with txtreme pain, high 
fever and an insufferable: burning sensation which,if not properly remedied, 
bring on dtath wiihin a fortnight, or ten days of their first appearance. 
These (vesicles) are called Vahni- Rohini. And again from another work 
he cites that a case of Vahm-Rohini due to the aciipn of the deranged 



88 THE SUSHRUTA SAMHITA. [Chap. XIII. 

(Kakshd) by bursting the local flesh, and which 
is attended with fever and a sensation as if a blazing 
fire is burning in the inside (of the affected part), are 
called Agni-Rohini. The disease is caused by the 
concerted action of the three deranged Doshas (Vayu, 
Pittam and Kapham). It is incurable and ends in the 
death of the patient either on the seventh*, tenth or 
fifteenth day (of its first appearance). 15. 

Chippam : — The deranged Vdyu and Pittam 
vitiating the flesh of the finger-nails, give rise to a 
disease which is characterised by pain, burning and 
suppuration. The disease called Chippam, is also 
denominated Upanakha and Kshataroga. Kuna- 
kham : — The nails of fingers becoming rough, dry, 
black, and injured through the action of the Doshas 
enraged through the effect of a blow, are called Kunakha 
(bad nails). It is also called Kulinam. Anusayi : — 
A small swelling (on the surface of the body) which is 
of the same colour (as the surrounding skin), but is 
deep-seated, and suppurates in its deeper strata, is called 
Anusayi by the physicians. The disease is the effect 
of the deranged Kapham. Vida(rika( :— A round reddish 
swelling rising either on the auxiliary or inguinal regions 
in the shape of a gourd ( Viddrikandd) is known as 
Viddrika. The disease is due to the concerted action 
of the deranged Vayu, Pittam and Kapham and 
is characterised by symptoms peculiar to each of 
them. 16—19, 



Kapham proves fatal within » fortnight, that due to the deranged Pittam, 
within ten days, and that due to the deranged Vayu, within a week. 

* The patient dies on the seventh day in a case of disease marked by 
the dominant Vayu, on the tenth day in a case marked by the dominant 
Pittam and on the fifteenth day in a case of dominant deranged Kapham. 



Chap. XIII.] NIDANA STHANAM. 89 

^arkararbudam :— The deranged Vayu and 
Kapham having recourse to and affecting the flesh, veins 
(S'ira), ligaments (Snayu) and fat give rise to a sort of 
cyst (Granthi) which when it bursts exudes a copious 
secretion in its nature somewhat like honey, clarified 
butter or Vasa. The aforesaid V^yu, when aggravated 
through excessive secretion, dries and gathers the flesh 
up again in the shape of (a large number of) gravel-like 
concretions (Sarkara) known accordingly as Sarkardrbu- 
dam. A fetid secretion of varied colour is secreted from 
the veins (Sira) in these Granthis which are sometimes 
found to bleed suddenly. The three varieties of the skin 
disease called Psbinat (Eczema), Vicharchikai (Psoriasis) 
and Rakasat have already been discussed under the head 
of Kushtham (Chapter. V.). 20-21. 

Padadarika :— The soles and feet of a person 
of extremely pedestrian habits become dry (and lose 
their natural serous moisture). The local Vayu thus 
aggravated gives rise to peculiar painful cracks 
(Dari in the affected parts) which are called Pada- 
darika. Kadara : — The knotty (Granthi), a painful, 
hard growth raised at the middle or sunk at the sides, 
which exudes a secretion and resembles an Indian 
plum (Kola— in shape), and appearing at the soles 
(palms according to — Bhoja) of a person as an outcome 
of the vitiated condition of the local blood and fat 
produced by the deranged Doshas incidental to the 
pricking of a thorn etc. or of gravel is called a Kadara 
(corns). Alasa : — An affection, caused by contact of 
poisonous mire and appearing between the toes, which 
is characterised by pains, burningj« itching and exuda- 
tion, is called Alasa. 22 — 25. 

Indralupta:--The deranged Vayu and Pittam 
having recourse to the roots of the hairs bring about their 

12 



^O THE SUSHRUtA SAMHITA. [Chap. XIll. 

gradual falling off, while the deranged blood and 
Kapham of the locality fill up those pores or holes, thus 
barring their fresh growth and recrudescence. The 
disease is called Indralupta,* Rujya or Khailitya (Alo- 
pecia). Dairunaka: — The disease in which the hairy 
parts of the body (roots of hairs) become hard, dry and 
characterised by an itching sensation is called Daru- 
naka. The disease is due to the action of the deranged 
Kapham and Vdyu. Arunshikat : — Ulcers (A runshi) at- 
tended with mucopurulent discharges and furnished with 
a number of mouths or outlets and appearing on the 
scalps of men as the result of the action of local 
parasites and of the deranged blood and Kapham (of 
the locality) are called Arunshika. Palitam : — The 
heat and Pittam of the body having recourse to the 
region of the head owing to overwork, fatigue, and ex- 
cessive grief or anger, tend to make the hair prema- 
turely grey, and such silvering of the hair (before the 
natural period of senile decay) is called Palitam. 
Masuriksi (variola) : — The yellow or copper-coloured 
pustules or eruptions attended with pain, fever and burn- 
ing and appearing all over the body, on (the skin of) the 
face and inside the cavity of the mouth, are called 
Masurikd. Yauvana-pidakat— (Mukhadushikai) :~The 
pimples like the thorns of a Salmali tree, which arefound 
on the face of young men through the deranged condition 
of the blood, Vdyu and Kapham, are called Yauvana- 
pidaki or pimples of youth. Padmini-Kantaka : 
— The circular, greyish patches or rash-like eruptions 

* Women are generally proof against this disease owing to their 
delicate constitution and to their being subjected to the monthly discharge 
of vitiated blood and at the same time to their undergoing no physical 
exercise, and hence there is little chance of the bodily Pittam being 
deranged and bringing on this disease. 



Chap. XIII.] NIDANA STHANAM. 9I 

Studded over with thorny papilla of the skin resembling 
the thorns on the stem of the lotus marked by itching 
are called Padmini-kantaka. The disease is due to the 
deranged condition of the Vdyu and Kapham. Yatu- 
mani (mole) : — The reddish, glossy, circular, and pain- 
less, congenital marks (Sahajam) or moles on the body not 
more elevated (than the surrounding skin) are called 
Yatumani. The disease is due to the deranged condition 
of the blood and Pittam. 26—33. 

IVIasaka (Lichen) : —The hard, painless, 
black and elevated eruptions on the body (skin) re- 
sembling the Mdsha pulse in shape, caused by the 
aggravated condition of the bodily Vayu are called 
Mas'aka Tilakalaka: — The black painless spots on 
the skin about the size of a sesamum seed and 
level with the skin are called Tilakalaka. This 
disease is caused through the aggravated condition of 
the Vayu, Pittam and Kapham .f Nyachcham: — The 
congenital, painless, circular, white or brown (Sydva) 
patches on the skin, which are found to be restricted 
to a small or comparatively diffused area of the skin, 
are called Nyachcham. Charmakila (hypertrophy of 
the skin) : — The causes and symptoms of the disease 
known as Charmakila have been already described 
(under the head of the Ars'a-Nidanam). Vyanga : — 
The Vayu being aggravated through wrath and over- 
fatiguing physical exercise, and surcharged with Pittam, 
and suddenly appearing on the face of a person, causes 
thin, circular, painless and brown-coloured patches or 
stains. They are known by the name of Vyanga * 34-38. 

* According to certain authorities it is due to the absorption of blood 
by Vayu and Pittam. 

+ According to others the spot goes by the name of Nilikam^ if it 
is black-coloured and appears anywhere other than on the face* 



92 THE SUSHRUTA SAMHITA. [Chap. XIII. 

The Parivartika :— The vital Vayu (Vydna) 
aggravated by such causes as excessive massage (mastur- 
bation), pressure, or local trauma, attacks the integuments 
of the penis (prepuce) which being thus affected by 
the deranged Vayu forms into a knot-like structure and 
hangs down from the glans penis. The disease known 
as Parivartika or Phymosis is due to the action of the 
deranged Vayu aggravated by any extraneous factor. 
It is marked by pain and burning sensation; and some- 
times suppurates. When the knotty growth becomes 
hard and is accompanied by itching, then it is caused by 
the aggravated Kapham. 39. 

Avapatika :~When the integuments of the 
prepuce is abnormally and forcibly turned back by such 
causes as coition under excitement, with a girl ^before 
menstruation and before the rupture of the hymen and 
consequently with a narrow external orifice of the vagina) 
or masturbation or pressure or a blow on the penis, 
or a voluntary retention o{ a flow of semen or forcible 
opening of the prepuce, the disease is called Avapdtikd 
or paraphymosis. Niruddha-prakatsa :— -The prepuce 
affected by the deranged Vayu entirely covers up the 
glans penis and thus obstructs and covers up the orifice 
of the urethra. In cases of partial obstruction a thin 
jet of urine is emitted with a slight pain. In cases 
of complete closing the emission of urine is stopped 
without causing any crack or fissure in the glans penis 
in consequence. The disease is called Niruddha-prakds a 
which is due to the deranged Vayu and is marked by 
pain (in the glans penis\ 39-41. 

Niruddhaguda :-The Vayu (Apana) obstruct- 
ed by the repression of a natural urging towards de- 
fecation stuffs the rectum, thus producing constriction 
of its passage and consequent difficulty of defeca- 



Chap. XIII.] NIDANA STHANAM. 93 

tion. This dreadful disease is known as Niruddha- 
gudam (stricture of the rectum) which is extremely 
difficult to cure. Ahiputana : — A sort of itch-like 
eruptions appearing about the anus of a child owing 
to a deposit of urine, perspiration, feces etc conse- 
quent on the neglect in cleansing that part. The 
eruptions which are the effects of the deranged blood 
and Kapham soon assume an Eczematous character 
and exude a purulent discharge on account of constant 
scratching. The Eczema (Vrana; soon spreads, and 
coalesces and proves very obstinate in the end. The 
disease is called Ahiputana. Vrishana-kachchu : — When 
the filthy matter, deposited in the scrotal integuments 
of a person who is negligent in washing the parts or 
in the habit of taking daily ablutions, is moistend 
by the local perspiration, it gives rise to an itching 
sensation in the skin of the scrotum, which is speedily 
turned into running Eczema by constant scratching 
of the parts. The disease is called Vrishana-kachchu 
and is due to the aggravated condition of the Kapham 
and blood. Guda-Bhransa : — A prolapse or falling out 
of the anus (due to the Vayu) in a weak and lean patient 
through straining, urging or flow of stool as in dysentery 
is called Guda-Bhransa or prolapsus ani. 42 — 45. 

Thus ends the thirteenth Chapter of the Nidana Sthanam in the 
Sus'ruta Samhita which treats of the Nidanam of minor ailments. 



CHAPTER XIV. 

Now we shall discourse on the Nidanam of the 
disease known as SukadOSha. i. 

Any of the eighteen different types of the disease 
may affect the genital (penis) of a man who foolishly 
resorts to the practice of getting it abnormally elongated 
and swollen by plastering it with Suka (a kind of 
irritating water insect) and not in the usual officinal way. 

Classification : — Diseases, which result from 
such malpractices, are knonwn as, — Sarshapika, Ashthi- 
lika, Grathitam, Kumbhika, Alaji, Mriditam, Sammudha- 
pidaka, Avamantha, Pushkarika, Spars'ahani, Uttama, 
Satoponaka, Tvakapaka, Sonitarvudam, Mansarvudam, 
Mansapaka, Vidradhi and Tilakalak. 2. 

Metrical Texts :— The tiny herpetic eruptions 
(Pidaka) which resemble the seeds of white mustard in 
shape and size, (and are found to crop up on the male 
organ of generation) on account of a deranged condition 
of the blood and Kapham, as the result of an injudicious 
application of Suka plasters are called Sarshapikai 
by the wise. Eruptions of hard stone-like pimples, 
(Pidaka) irregular at their sides or edges and which are 
caused by the aggravation of the local Vayu by the use 
of a plaster of the poisonous Suka, are called Ashthilika'. 
The knotty Granthis (nodules) on the penis owing 
to its being frequently stuffed with the bristles of a 
Suka insect are called Grathitam. This type is caused 
by the deranged action of the Kapham. A black wart 
resembling the stone or seed of a jambolin fruit in 
shape is called Kumbhikai. This type is due to the 
deranged condition of the blood and Pittam. 3 — 5. 



Chap. XIV.] NIJDANA STHANAM. 95 

An Alaji (incidental to an injudicious application 
of Suka on the penis) exhibits symptoms, which are 
identical with those manifested by a case of Alaji 
in Prameha (Ch. vi). A wart (papilloma) attended 
with swelling of the part and caused by the aggravated 
Vayu on the hard and inflamed penis causing pressure 
(on the urethra) is called Mriditam. The pustule or 
eruption appearing on the penis on account of its being 
extremely pressed by the hand i^for the insertion of the 
hairs of the Suka) in its dorsum is called Sammudha- 
pidaka^. (It is the outcome of the aggravated Vayu*). 
A large number of elongated pustules on the penis (in- 
cidental to an application of Suka to the part) which 
burst at the middle, causing pain and shivering, is called 
Avamantha (epithelioma ^ 6 — 10. 

The Pushkarika type of the disease is marked 
by the eruptions of small pimples around the principal 
one The type has its origin in the deranged condition 
of the blood and Pittam, and is so called from the part 
of the excrescenses being arranged in rings or circles like 
the petals of a lotus flower in shape. A complete anes- 
thesia (of the affected organ) owing to the vitiated blood 
by the injudicious application of a Suka is called Spars'a- 
haini. Pustules appearing on the penis through the 
vitiation of the local blood and Pittam by such con- 
stant applications are called Uttamsi. A suppuration of 
the prepuce under the circumstance is called Tvakapaikh. 
There is fever with a burning sensation in the affected 
organ. The disease is due to the vitiated condition 
of the blood and Pittam. 11-— 15. 

The type of the disease in which the penis is marked 
by the eruption of black vesicles and is covered over 
with a large number of red pimples or pustules with 

According to Dallana it is due to the action of Vayu and blood. 



g6 THE SUSHRUTA SAMHITA. tChap. XIV. 

an excruciating pain in the ulcerated region of the organ 
IS called Sonitafcrvudam. The vegetation of a fleshy- 
tumour on the penis (incidental to a blow on the organ 
to alleviate the pain of inserting the hairs of the Suka 
insect into its body), is called MsinsaLrvudam. A sup- 
puration as well as sloughing of the penis attended with 
different kinds of pain which severally mark the de- 
ranged Vayu, Pittam and Kapham is called Ma'nsa- 
paHia. This type is caused by the concerted action 
of the deranged Vayu, Pittam and Kapham. 15-18. 

The specific symptoms of a Tridoshaja Vidradhi 
as described before (Chap.ix.) mark the one which affects 
the penis (owing to an injudicious application of the 
highly poisonous irritant Suka to the organs) The 
disease is called Vidradhi. A process of general sup- 
puration and sloughing of the organ marks the type 
which is produced by the application of a black Suka or 
one of a variegated coloured insect of the same species. 
The type is called Tilakailaka, and should be regarded 
as Tridoshaja one. 19-21. 

ProgTIOSiS : — Of the above enumerated malig- 
nant diseases of the penis, those known as Mansarvuda, 
Mansapaka, Vidradhi and Tilakalak shoulda be deemed 
as incurable. 22. 

Thus ends the fourteenth Chapter of the Nidana Sthanam in the 
Sus'ruta Samhita which treats of Nidanam of different types of S'ukadohsa. 



CHAPTER XV. 

Now we shall discourse on the Nidanam of Bhagf-^ 
na.m (fractures and dislocations etc. of bones), i 

Various kinds of fracture may be caused from a 
variety of causes, such as by a fall, pressure, blow, 
violent jerking or by the bites of ferocious beasts etc. 
These cases may be grouped under the two main sub- 
divisions such as. Sandhi-Muktam (dislocation) and 
Ka^nda-Bhagnam (fracture of a kanda). 2. 

Cases of Sandhi-muktam (dislocation) may be divided 
into six different types, such as the Utplishtam, Visf- 
lishtanty Vivartitam, Adhak-Kshiptam, Ati-kshiptam and 
Tiryak-kshiptam. 3 . 

General features of a dislocation :^ 

Incapability of extension, flexion, movement, circum- 
duction and rotation (immobility, considered in respect 
of the natural movements of the joint), of the dislocated 
limb, which becomes extremely painful and cannot 
bear the least touch. These are said to be the general 
symptoms of a dislocation. 4. 

Diagnostic symptoms of a disloca- 
tion : — 'In case of a friction of a joint by two articular 
extremeties (Utplishtam) a swelling is found to appear 
on either side of the articulation attended with a variety 
of pain at night. A little swelling accompanied by 
a constant pain and disordered function of the dislocated 
joint, marks the case of simple-looseness (Vislishtam) 
of the articulation ; while pain and unevenness of the 
joint owing to the displacement of the connected bones 
distinguish a case of Vivartitam (lateral displacement). 
An excruciating pain, and looseness of the dislocated 

13 



98 THE SUSHRUTA SAMHITA. [Chap. XV. 

bone are the symptoms which characterise a case in 
which a dislodged bone is seen to drop or hang down 
from its joint (Adhah-kshiptam). In a case of abnor- 
mal projection (Ati-kshiptam), the dislocated bone is 
removed away from its joint which becomes extremely 
painful. A case of oblique dislocation (Tiryak-kshiptam) 
is marked by the projection or displacement of the 
bone on one side accompanied by a sort of intolerable 
pain. 5. 

Different kinds of Ksinda Bhag- 

nam : — Now we shall describe the Kanda-Bhagnam 
(fracture etc.). Fractures may be divided into twelve 
different kinds which are known as, Karkatakam, AsVa- 
karnam,Churnitam,Pichchitam,Asthi-chchalitam,Kanda- 
bhagnam, Majjagatam, Atipdtitam, Vakram, Chchinnam, 
Pdtitam and Sphutitam. 6. 

General symptoms of K^nda-bhag- 

nam : — A violent swelling (about the seat of fracture) 
with throbbings or pulsations, abnormality in the position 
(of the fractured limb), which cannot bear the least 
touch, crepitus under pressure, a looseness or dropping of 
the limb, the presence of a variety of pain and a sense of 
discomfort in all positions are the indications which 
generally mark all kinds of fracture (Kanda-bhagnam). 7. 
Diagnostic symptoms:— The case where a 
fractured bone, pressed or bent down at its two articular 
extremities, bulges out at the middle so as to resemble 
the shape of a knot (Granthi), is called Karkatam. 
The case where the fractured bone projects upward 
like the ear of a horse is called AsVakamam. The 
fractured bone is found to be shattered into fragments 
in a case of the Churnitam or comminuted kind which 
can be detected both by palpation and crepitation. 
A smashed condition of the fractured bone marks a 



Chap. XV.] NIDANA STHANAM. 99 

case of the Pichcliitain kind which is often found to 
be marked by a great swelling. The case where the 
covering or skin of the bone (periosteum) is cast or 
splintered off is called the Asthi-chchallitam. The 
case where the completely broken or severed bones are 
found to project through the local skin, is called Katada- 
bhagnatn (compound). The case where a fragment of 
the fractured or broken bone is found to pierce into the 
bone and dig out the marrow, is called Majjsiaugatain, 
(Impacted fracture). The case where the fractured bone 
droops or hangs down is called Ati-paititani. The case 
where the unloosened bone (from its position) is bent 
down in the form of an arch is called Vakram The 
case where only one articular extremity of the bone is 
severed is called Chhinnaoi. The case where the bone 
is slightly fractured and pierced with a large number 
of holes, is called PaLtitam, an excruciating pain being 
the leading indication. The case where the bone largely 
cracked and swollen becomes painful as if stuffed with 
the bristles of a Suka insect is called Sphutitam (Green- 
stick fracture). Of the several kinds of fracture, cures 
are effected with extreme difficulty in a case of the 
Churnitam, Chhinnam, Ati-patitam or Majjanugatam 
kind. A case of displacement or laxation occurring 
in a child or in an old or weak patient or in one suffer- 
ing from asthma (Svasa) or from any cutaneous affec- 
tion (Kushtha) or Kshata-Kshina disease is difficult to 
cure. 8. 

Memorable verses : —The following cases 

are to bs given up as hopeless —z^/s. fracture of the 
pelvic bone (or of bones that are of this description, 
wherever they may be situated) ; dislocation of the 
pelvic joints ; compound fracture of the thigh bone or 
of the flat bones) ; fracture into small pieces of the 



lOO THE SUSHRUTA SAMHITA. [Chap. XV. 

frontal bone or its dislocation ; simple fracture of the 
breast-bones, back-bone and temporal and cranial bones. 
If the dislocations and fractures be improperly set 
from the outset (Adito)* or if the union be anyhow 
disturbed there is no hope for recovery. 9 — 11. 

If fractures happen at any time of the first three 
stages of adalt life which has been described before 
(vide Sutrasthana Chap, XXXV.) and if they are set up 
by an able surgeon they have a great chance of being 
united. 12. 

A bending of a gristle or cartilage (Taruna) is 
called its fracture. A Nalaka (long bone) bone is 
usually found to be severed. A Kapatla bone is found 
to be cracked, while a Ruchakaf (tooth) is found to be 
splintered off. 13. 

* The word Adiio may be taicen into the sense of congenital mal- 
formation which is beyond remedy. 

+ The presence of the particle 'cha' denotes Valya-asthi- 

Thus ends the fifteenth Chapter of the Nidana Sthanam in the Sus'ruta 
amhit^ which treats of the Nidanam of dislocations and fractures. 



CHAPTER XVI. 

Now we shall discourse on the Nidanam of 
lYl Uk ha. Tog's. m (diseases which affect the cavity of 
the mouth in general), i. 

General Classifications:— Sixty five* dif- 
ferent forms of mouth disease are known in practice. 
They are found to attack seven different localities viz. 
the lips, the gums of the teeth, tongue, palate, throat and 
the entire cavity ; of these eight are peculiar to the lips ; 
fifteen, to the roots of the teeth; eight to the teeth; 
five to the tongue ; nine to the palate ; seventeen to 
the throat; and three to the entire cavity. 2 — 3. 

Diseases of the lips :— The eight forms which 
affect the lips, are either Vataja, Pittaja, Kaphaja, Sanni- 
pdtika, Raktaja, M^ns'aja, Medaja or Abhighdtaja 
(Traumatic). 4. 

The Vsitaja Type:— The lips become dry, 
rough, numbed, black, extremely painful and the affected 
part seems as if it were smashed and pulled out or 
cracked by the action of the aggravated Va(yu. In the 
Pittaja type — the lips become blue or yellow-coloured 
and studded with (a large number of small) mustard- 
seed-like eruptions, which suppurate and exude a puru- 
lent discharge attended with a burning sensation (in 
the locality). In the Kaphaja type — the affected lips 
are covered with small eruptions, which are of the same 
colour as the surrounding part, and become slimy, heavy 
or thick, cold and swollen. Pain is absent in this type 
and the patient feels an irresistible inclination to scratch 
the parts. In the Satnnipaitaja type, the lips change 

* According to others sixty-seven-^but Dalian does not support this. 



102 THE SUSHRUTA SAMHITA. [Chap. XVI. 

colour, becoming black, yellow, or ash-coloured (white) 
at intervals and are found to be studded with various 
sorts of eruptions. 5 — 8. 

The Raktaja type :— (Produced by the vitiated 
condition of the blood) the affected lips look as red as 
blood and profusely bleed and crops of date coloured 
(chocolate-coloured) eruptions appear on their surface. In 
the Maknsaja type (due to the vitiated condition of the 
local flesh), the lips become heavy, thick and gathered up 
in the form of a lump of flesh. The angles of the 
mouth become infested with parasites which germi- 
nate and spread themselves in the affected parts. In 
the Medaja(fat-origined) type the lips become numbed, 
soft, heavy and marked by an itching sensation. The 
skin of the inflamed surface becomes glossy and looks 
like the surface layer of clarified butter exuding a thin 
crystal-like (transparent) watery discharge. In the 
Abhighaitaja (Traumatic) type, the lips become red, 
knotty and marked by an itching sensation and seem as 
if (pierced into or cut open with an axe and (become 
cracked and fissured). 9 — 12. 

Disease of the roots of the teeth ;— 

Diseases which are peculiar to the roots of the teeth, are 
known as Sitada, Danta-pupputaka, Danta-veshtaka, 
Saushira, Mdha-Saushira, Paridara, Upakus'a, Danta- 
vaidarbha, Vardhana, Adhimansa and the five sorts -of 
Nddi (,sinus). 13. 

Sitada (Scurvy); — The gums of the teeth suddenly 
bleed and become putrified, black, slimy and emit a fetid 
smell. They become soft and gradually slough off. 
The disease has its origin in the deranged condition 
of the local blood and Kapham. Dantapupputaka 
(gum boil): — The disease in which the roots of two or 
three teeth at a time is marked by a violent swelling and 



Chtip. XVI.] NIDANA STHANAM. 1 03 

pain is called Danta-pupputaka. The disease is due 
to the vitiated condition of the blood and Kapham. 
Danta-veshtaka: — The teeth become loose in the gums, 
which exude a discharge of blood and pus. This disease 
is due to the vitiated blood of the locality. Saushira:— 
The disease in which an itching painful swelling appears 
about the gums attended with copious flow of saliva is 
called Saushira (Alveolar abscess). It is caused by the 
deranged blood and Kapham of the locality. Maha(- 
Saushira : — The disease in which the teeth become loose, 
the palate marked by sinuses or fissures, the gums putri- 
fied, and the whole cavity of the mouth inflamed, is 
called Mahas'aushira, the outcome of the concerted action 
of the deranged Doshas of the body. 14 — 18. 

Paricla.ra. : — The disease in which the gums be- 
come putrified, wear off and bleed is called Paridara 
(bleeding gums\ The disease has its origin in the 
deranged condition of the blood, Kapham and Pittam. 
Upakusa :~The disease in which the gums become 
marked by a burning sensation and suppuration and 
the teeth become loose and shaky (in their gums) in 
consequence and bleed at the least shaking, is called 
Upakusa. There is a slight pain, and the entire cavity 
of the mouth becomes swollen and emits a fetid smell ; 
this disease is due to the vitiated condition of the 
blood and Pittam. 19. 

Danta-Vaidarbha :— The disease which is 
consequent upon the friction of the gums marked by the 
appearance of a violent swelling about the portion (so 
rubbed and in which) the teeth beeome loose and can be 
moved about, is called Danta-vaidarbha which is due to 
an extraneous cause such as a blow etc. Vardhana : — 
the disease which is marked by the advent of an 
additional tooth (the last molar) through the action 



t04 THE SUSHRUTA SAMHITA. [Chap. XVI. 

of the deranged Vayu with a specific excruciating pain 
of its own, is called Vardhana or eruption of the Wisdom 
tooth. The pain subsides with the cutting of the tooth. 
Adhimainsa :— The disease in which a violent and 
extremely painful tumour appears about the root of the 
tooth, and is situated in the farthest end of the cavity of 
the cheek-bone accompanied by a copious flow of saliva 
"is called Adhimansa or Epulis. It is due to the 
deranged Kapham. The five sorts of Na'di (sinus) 
which affect the roots of the teeth (are either Vataja, 
Pittaja, Kaphaja, Sdnnipataja or Abhighataja), their 
symptoms being respectively identical with those of the 
types of Nadi-vrana. 20 —24. 

Diseases to the teeth proper :— Diseases 

which are restricted to the teeth proper are named as, 
Ddlana, Krimi-dantaka, Danta-harsha, Bhanjaka, Sarkard, 
Kapalika, Syiva-dantaka and Hanu-moksha. 25. 

Dalana : — The disease in which the teeth seem 
as if being cleft asunder with a violent pain is called 
Deilana or toothache, the origin of which is ascribed 
to the action of the aggravated state of the bodily Vayu. 
Krimi-dantaka : — The disease in which the teeth are 
eaten into by worms, is called Krimi-dantaka (caries\ 
The teeth become loose and perforated by black holes 
accompanied by a copious flow of saliva. The appear- 
ance of an extremely diffused swelling (about the roots of 
decayed teeth) with a sudden aggravation of the accom- 
panying pain without any apparent cause is also one 
of its specific features. Danta-harsha : — The disease 
in which the teeth cannot bear the heat, cold or touch is 
called Danta-harsha. It is due to the deranged condi- 
tion of Vdyu. Bhanjaka : — The disease in which the 
face is distorted, the teeth break, and the accompanying 
pain is severe, is called Bhanjaka (degeneration of the 



Chap. XV 1 ] NIDANA STHANAM. 10^ 

teeth). The disease is due to the deranged condition of 
the Vayu and Kapham. Sarkaiai : — The disease, in 
which sordes, formed on the teeth and hardened (by the 
action of the deranged Vayu), lie in a crystallised form 
at the roots of the teeth, is called Sarkara (Tartar). 
Such deposits tend to destroy the healthy growth and 
functions of the teeth. Kapalikai : — The disease in which 
the preceding crystallised deposits get cemented together 
and afterwards separate from the teeth taking away a part 
of their coating (enamel) is called Kapalika (calcareous 
deposit) which naturally makes an erosion into and 
destroys the teeth Sya^va-dantaka :— The disease, in 
which the teeth variously scorched by the action of the 
deranged Pittam assumes a blackish or blue colour, is 
named as Syava-dantaka (black teeth). Hanu-moksha : — 
The disease in which the Vayu aggravated (by such 
causes, as by loud talking, chewing of hard substances, 
or immoderate yawning) produces the dislocation of the 
jawbones is called Hanu-moksha It is identical with 
Ardditam as regards its symptoms. 26-33. 

Diseases of the tongue :— The five kinds 

of diseases which affect the organ of taste are the 

three sorts of Kantakas due to the three deranged 

Doshas (Vataja Pittaja and Kaphaja), AUsa and 
Upa-jihvika. 34. 

The three Kantaks :— In the Vataja Kan- 

taka type the tongue becomes cracked, loses the 
sense of taste and becomes rough like a teak leaf 
(giving the organ a warty appearance). In the Pittaja 
Kantaka form the tongue is coloured yellow and studded 
over with furred blood-coloured papillae with the burning 
sensation (of the Pittam in them). In the Kaphaja 
Kantaka type the tongue becomes heavy, thick and 
grown over with vegetation of slender fleshy warts in the 

14 



to6 THE SOSHRUTA SAMHitA. CChap. XVI. 

shape o{ S'almali thorns. Alsbsa :- The severe inflam- 
matory swelling about the under surface of the tongue 
is called Alasa, which if allowed to grow on unchecked 
gives rise to numbness and immobility of the organ 
and tends to a process of rapid suppuration at its base. 
The disease is caused by the deranged blood and 
Kapham. The Upa-jihva^ : - The disease in which a 
(cystic) swelling shaped like the tip of the tongue 
appears about the under-surface of that organ by raising 
it a little is called Upa-jihvika (Ranula). The accom- 
panying symptoms are salivation, burning and itching 
sensations in the affected organ ; these are due to the 
deranged Kapham and blood (of the locality). 35 — 37. 

Disease of the palate : — Diseases which are 
peculiar to the part of the palate are named Gala-s'undika, 
Tundikeri, Adhrusha, Mansa-kachchapa, Arvuda, Mansa- 
sanghata,, Talu-s'osha and Talu-pdka. 38. 

Gala-SUndika :— The diffused and elongated 
swelling, caused by the deranged blood and Kapham, 
which first appears about the root of the palate and 
goes on extending till it looks like an inflated skin- 
bladder is called Gala-s'undikd (tonsilitis) by physicians. 
Thirst, cough, difificult breathing are the indications of 
the disease. Tundikeri : — A thick swelling resembling 
the fruit of the Tundikeri plant in shape and appearing 
about the root of the palate attended with a burning, 
piercing or pricking pain and suppuration is called 
Tundikeri (abscess of the tonsil). Adhrusha :— A red, 
numbed svvelling appearing about the same region, as 
the effect of the vitiated blood of the locality, attended 
with severe fever and pain, is known by the name of 
Adhrusha. Mjinsa-kachchapa:— A brownish and slightly 
painful swelling somewhat shaped like the back of a 
tortoise (and appearing about the region of the soft 



Chap. XVI.] NIDANA STHANAM. lo; 

palate) is called Mdnsa-kachchhapa. The disease is, 
slow in its growth or development and is due to the 
deranged Kapham. Arvuda: — A swelling shaped like 
the petal of the lotus lily and appearing in the region 
of the soft palate as an outcome of the aggravated con- 
dition of the local blood is called Arvudam. The 
swelling is identical with the Raktarvuda described 
before. Mausa-Saiighata :— A vegetation of morbid 
flesh at the edge or extremity of the soft palate 
through the action of the derani^ed Kapham is called 
Mansa-Sanghata. It is painless. Ta!u-piipputa: — A 
painless permanent swelling to the shape o( the Kola 
fruit (plum) caused by the deranged fat and Kapham 
at the region of the soft palate is called Tdlu-pupputa. 
Tatiu-sosha :— The disease of the soft palate in which 
the patient feels a sort of parched sensation with 
dyspnoea and a severe piercing pain in the affected 
part is called T^llu-sosha, which has its origin in the 
aggravated condition of the bodily Vayu acting in 
concert with the deranged Pittam. Ta^lu-patka — The 
disease in which the deranged Pittam sets up a very 
severe suppurative process in the soft palate is called 
Talu-paka, 39-47. 

The diseases of the throat and 

larynx : —The diseases peculiar to the throat and the 
larynx are seventeen in number and are known as 
the five types of Pohini, Kantha-Saluka, Adhijihva, 
Valaya, Valasa, Eka-vrinda, Vrinda, Sataghni, Gilayu, 
Gala-vidradhi, Galaugha, Svaraghna, Mansatana. and 
Viddri. 48. 

General features of Rohinis:-The 

aggravated Vayu, Pittam, Kapham, either severally or 
in combination, or blood may affect the mucous of 
the throat and give rise to vegetations of fleshy papillae, 



lo8 THE SUSHRUTA SAMHITA. [Chap. XVI. 

which gradually obstruct the channel of the throat 
and bring on death. The disease is called Rohini 
(Diphtheria^i. 49. 

The V^taja Rohini :~A vegetation of ex- 
tremely painful fleshy Ankuras (nodules), crops up all over 
the tongue which tend to obstruct the passage of the 
throat and are usually accompanied by other distressing 
symptoms characteristic of the deranged Vayu. Pittaja- 
Eohini :— The Ankuras (nodules) in the present type are 
marked by speedy growth and suppuration, and are 
accompanied by a burning sensation and high fever. 
Kaphaja Rohini : —The Ankuras (nodules) become 
heavy, hard and characterised by slow suppuration 
gradually obstructing the passage of the throat. 50-52. 

The Sannipatika Type :— Suppuration 

takes place in the deeper strata of the membrane ac- 
companied by all the dangerous symptoms peculiar to 
the three aforesaid types of the disease. It is rarely 
amenable to treatment. Rakfcaja Type : -Symptoms 
characteristic of the Pittaja type of the disease are 
present and the fleshy outgrowth formed in the throat, 
is found to be covered with small vesicles. This type 
is incurable.* 53~54 

Kantha-^alukam : -The disease in which a 
hard rough nodular growth (Granthi) in the shape of a 
plum-stone crops up in the throat, which seems as if it 
has been stuffed with the bristle of a S'uka insect or 
been pricked by thorns is called Kantha-Salukam. The 
disease is due to the action of the deranged Kapham. 
It is amenable to surgical treatment only. Adhijihva : — 
A small swelling like the tip of the tongue caused by the 

* The reading Sadhya (curable) which is to be met with in the several 
printed editions of Madhab's Nidanam in lieu of the reading Asadhya 
'incurable) is not to our mind correct, 



Chap. XVI.] NIDANA STHANAM. I09 

deranged blood and Kapham over the root of the tongue 
is called Adhijihva, which should be given up as soon as 
suppuration sets in. Valaya :— A circular or ring-shaped 
raised swelling obstructing or closing up the upper end of 
the oesophagus (structure of oesophagus) is called Valaya. 
It cannot be cured and hence should be given up. It is 
due to the deranged action of the Kapham in the 
locality. Valatsa : —The disease in which the unusually 
aggravated Vayu and Kapham give rise to a swelling 
in the throat, which is extremely painful and causes a 
difficulty of respiration, ultimately producing symptoms 
of complete asphyxia is called Valasa by learned 
physicians and is very difficult to cure. 55 — 58. 

Eka-vrinda and Vrinda*:— The disease in 

which a circular, raised, heavy and slightly soft swelling 
appears In the throat attended with Itching, a slightly 
burning sensation and a slight suppuration is called 
Eka-vrinda. The disease is due to the effect of vitiated 
blood and Kapham. The disease in which a round 
elevated swelling attended with high fever and a slightly 
burning sensation is formed in the throat through the 
aggravated condition of the blood and Pittam is called 
Vrinda. A piercing pain in the swelling points to its 
Vataja origin. 59—60. 

^atagChni : — The disease in which, through the 
concerted action of the deranged Vayu, Pittam and 
Kapham, a hard throat obstructing Varti fjagged mem- 
brane; edged like a Sataghni-f and densely beset with 
fleshy excrescences is formed along the inner lining of 

* The diseases of the throat are 17 in number. Taking Vrinda as a 
separate disease they amount to 18 ; but Vrinda, affecting similar place 
and being similar in appearance with but a slight distinction of symptoms, 
is only a particular state of Eka-vrinda, and not a separate disease. 

t Sataghni is a kind of weapon uged in ancient warf?ire, 



iro THE SUSHRUTA SAMHITA [Chap. XVI. 

that pipe is denominated as Sataghni. Various kinds 
of pains, (characteristics of each of the deranged Vayu, 
Pittam and Kapham) are present in this type which 
should be necessarily considered as irremediable. 6i. 

GilStyu : — The disease in which the aggravated 
Kapham and blood give rise to a hard and slightly 
painful (D. R extremely painfull glandular swelling 
in the thrviat to the siz^ of the stone of the Amalaka 
fruit is called Gilayu. A sensation as if a morsel or 
bolus of food is stuck in the throat is experienced which 
by its very nature is a surgical case. 62. 

Gala-vidradhi: — Thediseascin whichan exten- 
sive swelling occurs along the whole inner lining of the 
throat, owing to the concerted action of the deranged 
Vayu, Pittam and Kapham is called Gala-vidradhi which 
exhibits all the features present in a Vidradhi of the 
Sanipatika type. Galaugha : — The disease in which a 
large swelling occurs in the throat so as to completely 
obstruct the passage of any solid or liquid food and also 
that of Udana-vayu (choking the pharynx, larynx and 
the mouth of the esophagus), attended with a high fever 
is called Galaugha, the origin of which should be as- 
cribed to the action of the deranged blood and Kapham. 
Svaraghna: -The disease in which the patient faints 
owing to the choking of the larynx by the deranged 
Kapham which is marked by stertorous breathing, hoarse- 
ness, dryness and paralysed condition of the throat is 
called Svaraghna which has its origin in the deranged 
Vayu. 63—65. 

IVIanSatana : — The disease in which a pendent, 
spreading and extremely painful swelling appears in 
the throat which gradually obstructs the pipe is called 
Mansatana. It invariably proves fatal and is caused 
by the deranged Vdyu, Pittam ^nd Kapham 6() 



Chap. XVI.] NIDANA STHANAM. til 

Vidari : -The disease In which a copper-coloured 
swelling occurs in the throat, marked by a pricking and 
burning sensation, and the flesh of the throat gets 
putrefied and sloughs off (and emits a fetid smell) is 
called Vidari. The disease is of a Pittaja origin and is 
found to attack that side of the throat on which the 
patient is in the habit of lying. 6^. 

The disease in the entire cavity: — 

Cases which are found to invade the entire cavity of 
the mouth (without being restricted to any particular 
part thereof) may be either due to Vataja, Pittaja, 
Kaphaja or Raktaja type and are known by the general 
name — Savra-Sara. (i"^. 

In the Vataja type the entire cavity of the mouth 
is studded with vesicles attended with a pricking 
sensation in their inside. In the Pittaja type a large 
number of small yellow or red-coloured vesicles attended 
with a burning sensation crops up on the entire (mucous 
membrane lining the cavity of the mouth. In the Kaphaja 
variety a similar crop of slightly painful, itching vesicles 
of the same colour as the skin (is found on the entire 
inner surface of the mouth.) The blood-origined Kaktaja 
type is nothing but a modification of the Pittaja one 
(giving rise to similar symptoms) ; it is also by others 
called Mukha-patka. 69-72. 

Thus ends the sixteenth Chapter of the Nidana Sthanam in the Sus'ruta 
Samhita which treats of the Nidanam of the diseases of the mouth. 



Here ends the Nidana Sthanam. 



THE 

SUSRUTA S AMHIT A 

SARIRA STHANAM. 

(Section on Anatomy). 
-.o: 

CHAPTEE L 

Now we shall discourse on the Sdriram which treats 
of the science of Being in general (Sarva-Bhuta 

Chintsi ^gfriram). i. 

The latent (lit : unmanifest) supreme nature (Prakriti) 
is the progenitor of all created things. She is self- 
begotten and connotes the three fundamental or primary 
virtues of Sattva, Rajas and Tamas. She is imaged or 
embodied in the eightfold categories of Avyakta (un- 
manifest), Mahdn (intellection), Ahamkdra (Egoism) and 
the five Tanmdtras or elementals (proper sensibles) and 
is the sole and primary factor in working out the evo- 
lution of the universe. The one absolute and original 
nature is the fundamental stone house of materials out 
of which the bodies of all self-conscious (Karma-Purusha) 
working agents (agents who come into being through the 
dynamical energy of their acts or Karmas) have been 
evolved in the same manner as all water, whether con- 
fined in a tank or a reservoir, or coursing free through 
the channels of streams and of mighty rivers, have been 
welled up from the one and shoreless primordial ocean. 2. 

Out of that latent unmanifest (Avyakta) or original 
nature (impregnated by the atoms or elemental units of 

15 



ri4 THE SUSHRUTA SAMHITA. [Chap. I. 

consciousness or Purushas) Intellection or Mahdn has 
been evolved, and out of Mahdn egoism. This Mahan or 
intellection should be likewise considered as partaking 
of the three fundamental attributes (Sattva, Rajas, and 
Tamas) of the latent (Avyakta) or original nature.* 
Ahamkara or egoism in its turn may be grouped under 
three subheads as the Vaikdrika Taijasa (operative) or 
Rdjasika, and Bhutadi (illusive or Tamasika). 3. 

The eleven organs of cognition, communication or 
sense perception have emanated from the co-operation 
of the aforesaid Vaikarika Ahamkara with the Taijasa 
or Rajasa. They are the ears, skin, eyes, tongue, nose, 
speech, hands, genitals, anus, feet and the mind (Manah). 
Of these foregoing organs the first five are intellectual 
or sense organs (Vuddhi-Indriya) ; the next five being 
operative (Karma-Indriya\ The mind (Manah) par- 
takes of the character of both the intellectual and 
operative organs alike. 4-5. 

The five Tanmatras or elementals (or the five proper 
sensibles of hearing, touch, sight, taste, and smell) charac- 
terised by the Nescience, etc. have been evolved out of the 
Bhutddi etc. (or Tamasa Ahamkara) concerted with the 
Taijasa Ahamkdra through the instrumentality of the 
Vaikarikam. The gross or perceptible modifications of 
these five Tanmatras are sound, touch, taste, sight and 
smell. From the combination of the aforesaid five 
Tanmdtras (Bhutadi) taken one at a time, have succes- 
sively emanated the five gross matters of space such as 

* Sattva, Rajas and Tamas :— Adhesion, cohesion and disintegration 
in the Physical plane ; affection, love and hate in the moral ; emancipa. 
tion, spiritual affinity and sin in the Psychic. 

Simply phenomenal or the simple outcome of the phenomenal evolution 
without being by othet specific attributes of matter and hence Skttvika or 
iUuminatiDg or quasi-spiritual. 



Chap, i.] SARIRA STHaNAM. 11$ 

ether, air, heat, (fire,) fluid (water), and earth (solid). 
These twenty four categories combinedly form what is 
technically known as the twenty four elements 
(Tattvas). Thus we have discoursed on the twenty four 
fundamental principles (Chaturvins'ati-tattvam). 6. 

Hearing, touch, sight, taste and smell respectively 
form the subjects of the five intellectual (Vuddhi) 
organs of man, whereas the faculty of speech, handling, 
pleasure, ejections or evacutation, locomotion successively 
belong to the (remaining) five operative (Karma-Indriya) 
ones. The original nature (Avyakta), Mahan* (intellec- 
tion), Egoism (Aliamkara),the five sensibles (Tanmatras), 
and the five gross material principles in their nascent 
stage in evolution form what is included within the eight 
categories of Nature (Prakriti), the remaining sixteen 
categories being her modifications (Vikara), The objects 
of intellection (Mahan) and Egoism (Ahamkdrd) as well 
as of the sense organs of knowledge and actions are the 
material principles (Adibhautika) though they are spiri- 
tual in themselves and in their nature. 

The tutelary god of intellection (Buddhi) is Brahma. 
The god Is'vara is the presiding deity of the sense of 
egoism (Ahamkdra) ; the moon god is that of the mind 
(Manah) ; the quarters of the heaven, of the ears ; the 
wind god is that of the skin ; the sun is that of the 
eyes ; the water is that of the taste ; the earth is that of 
the smell ; the fire is that of the speech ; Indra is that of 
the hands ; Vishnu is that of the legs ; Mitra is that of 
the anus and Prajapati is that of the organs of 
generations. 7. 

* Mahan, Ahamkara and the five Tanmatras, though but modifications 
of the original Nature in themselves, have been included within the 
category of Nature (Prakriti) in asmuch as they form the immediately prior 
or antecedent conditions of the evolution of the phenomenal universe. 



ri6 THE SUSHRUTA SAMHITA. [Chap. t. 

All the aforesaid (twenty-four) categories or 
elementals (Chaturvinsati-Tanmdtras) are devoid of 
consciousness. Similarly the modifications of the 
primal cause of Prakriti such as the Mahat etc. are 
all bereft of consciousness in as much as the cause 
itself, the Avyakta or the original nature is devoid of 
it. The Purusha or the self-conscious subjectivity, 
enters into the primal cause (Mula-Prakriti or original 
Nature) and its necessary effect (the evolved out 
phenomena) and makes them endued with his own 
essence or self-consciousness. The preceptors and holy 
sages explain the proposition by an analogy that as 
the milk in the breast of a mother, though unconscious 
in itself, originates and flows out for the growth and 
sustenance of her child ; (as the semen in the organism 
of an adult male though devoid of consciousness, flows 
out during an act of sexual intercourse) ; so these 
twenty-four primary material principles (elementals), 
though unconscious in themselves, tend to contribute 
towards the making of the self-conscious self or the 
universal individual (the aggregate of limited or condi- 
tional selves) for the purpose of working out his final 
liberation or emancipation i.e., attainment of the stage of 
pure consciousness or perfect knowledge. 8. 

Now we shall describe the tracts which the Purusha 
(subjective or self-conscious reality) and Prakriti or 
nature (passive non-conscious eternity) pass in com- 
mon as well as those wherein they differ from each 
other. 9. 

Traits of commonalty :—Both the Purusha 
and Prakriti are eternal realities, both of them are un- 
manifest, disembodied, without a beginning or origin, 
eternal, without a second, all — pervading and omni* 
present. 



Chap. I.] SARIRA StHANAM. II? 

Traits of diversity :— Of the Purusha and 

the Prakriti, only the latter is non-conscious and 
possesses the three fundamental qualities of Sattva, 
Rajas and Tamas. Prakriti performs the function 
of the seed or in otherwords she lies inherent as the 
seed or the primary cause in the latter phenomenal 
evolution of the Mahat etc. and contributes the maternal 
element in the conception, development and birth of 
the primordial cosmic matter (phenomenal universc\ 
fecundated by the Purusha (self-conscious subjectivity) 
in its different stages of evolution. These stages are 
called Mahat, Ahamkara etc. ; and Prakriti is not indif- 
ferent, as the Purusha is to the pleasures and misery of 
life. But the Purusha (units or atoms of consciousness), 
devoid of the threefold virtues of Sattva etc. are non- 
concerning hence non-producing and bereft of the seed- 
attributes of lying inherent in all as the primary 
cause of evolution. They are mere witnesses to the 
joys and miseries of life, and do not participate in their 
enjoyment though imprisoned in the human or- 
ganism. 10 

Since an effect is uniform in virtue to its producing 
cause, the evolution ised effects or products of the Pra- 
kriti such as the Mahat, Ahamkara etc. must needs par- 
take of the three fundamental qualities (Sattva, Rajas 
and Tamas) which are predicated of the Prakriti. In 
other words, these Mahat, Ahamkara, etc, are but the 
modifications of the three fundamental qualities of 
Sattva, Rajas and Tamas. Moreover, certain authorities 
hold that the Purushas are units of self-consciousness, 
possessed of the three aforesaid qualities owing to their 
antecedent conditions or causes (the gross material 
universe) being permeated with and characterised by 
them. II. 



Il8 THE SasHRUTA SAMHITA. [Chap. 1. 

IVIetrical Text (Vaidyake.) :— It is asserted in 
the Ayurveda that it is only the gross-sighted ones 
and men capable of observing only the superficial 
appearances, who confound eternal order or se- 
quence of things and events (Svabhd,ba), God ( Is vara) * 
Time (Kala), sudden and unlooked for appearances 
of the phenomena (Yadrichchha), Necessity (Niyati) and 
transformation (Parinama) with the original Nature 
(Prakriti). The five different forms of matter (such as 
Ether etc ) are nothing but the modifications or trans- 
formed states of the original nature and are characterised 
by the three universal qualities of Sattva, Rajas and 
Tamas, and all created things, whether mobile or im- 
mobile, should be considered as alike exponented by the 
same. In the Science of medicine the cause of a 
disease is the one sole aim to be achieved by means of 
administering proper medicinal remedies (matter), and 
hence the properties of matter are the only fit subject 
to be dealt with in a book on pharmacy. And further, 
because the immediately prior cause of the human 
organism is a proper and congenial admixture of the 
sperm and ovum (matter), the sense organs are the 
resultants of phenomenal — evolution of matter, and the 
objects of sense perception are equally material or 
phenomenal in their nature. 12-14, 

IVlemorable verse : -A man by a particular 
organ of his body perceives the same matter which 
forms the proper object of that sense organ in as much 
as the perceiving sense organ and the perceived sensible 
are produced by the same material cause. The matter, 

* The second factor according to Sankhya, in the order of cosmic 
evolution, which as the seed of the universe, was hid in the burning disc 
of the central, primordial Sun, out of which the different solar systems 
have come into being. 



Chap. I.] SARIRA STHANAM. II9 

which specifically forms the object of a particular sense 
organ, cannot be perceived by the other. We see a 
flower with the eyes and not with the nose. 15. 

The Science of medicine does not lay down that the 
self-conscious Selves (Kshetrajna) are all pervading, but 
on the contrary it asserts that they are real and eternal 
and are born in the planes of divine, human or animal 
existence according to their good or evil deeds in life. 
The existence of these self-conscious entities can be 
ascertained duly by inference inasmuch as they are 
extremely subtle in their essence. The self-conscious 
self is possessed of infinite consciousness, is real and 
eternally subject to the process of being evolved out 
into a finite, organic individual through the dynamics 
of the combined sperm and ovum. The view is further 
corroborated by a dictum of the Sruti which holds that 
Purusha (individual) is nothing but a combination of 
a self-conscious self and the five kinds of matter (Maha- 
bhutas) formed into an organic body. This Purusha or 
individual, which is called Individual of action (Karma- 
Purusha), falls within the scope of the science and art 
of medicine.* 16 — 17. 

* Here lies the difference between Sankhya and Ayurveda. While the 
former discourses on in material character of the soul, the latter com- 
mences to discuss on the questions how the material environment in 
which the soul is said to inhabit is evolved, and how the inclusion of 
the spiiilual within the material organism is effected. 

Hence Sus'ruta's Physiology, like that of Charaka, is in the strictest 
sense of the word molecular and his science of life is an attempt at 
explanation of consciousness from the materialistic standpoint, which 
agrees with the views of modern western science. Intellect according to 
Sus'ruta is material and belongs to the same category which the Sankhya 
system of philosophy in its explanation of evolution enumerates originally 
as seven. The soul, accordtng to Sus'ruta, is an independent existence and 
is often associated with what is called life. Where there is life, there is a 
soul, and it is not everywhere the same. The soul in Sus'cula is individual 



120 THE SUSHRUTA SAMHITA. [Chap. I. 

The attributes of an organic indi- 
vidual : — Longing for pleasure, shunning of pain, 
enemity, energetic undertaking of work, respiration 
(Prdna\ emission of flatus (Apana), closing and opening 
of the eyelids, intellect (Vuddhi), sentiment (Manah), 
deliberation, discretion, memory, knowledge of art, 
perseverance, sensation and perception, are the attributes 
of an organic individual. i8. 

Distinctive features of the different 
classes of mental temperaments :— An 

absence of all killing or hostile propensities, a judicious 
regimen of diet, forbearance, truthfulness, piety, a belief 
in God, spiritual knowledge, intellect, a good retentive 
memory, comprehension, and the doing of good deeds 
irrespective of consequences, are the qualities which 
grace the mind of a person of a Sa'ttvika temperament. 
Feeling of much pain and misery, a roving spirit, non- 
comprehension, vanity, untruthfulness, nonclemency, 
pride, an over winning confidence in one's own excel- 
lence, lust, anger and hilarity are the attributes which 
mark a mind of the Raijashika cast. Despondency, 
stupidity, disbelief in the existence of God, impiety, 
stupification and perversity of intellect, lethargy in 
action and sleepiness are the qualities which mark a 
mind of a Taimasliika stamp. 19, 

The distinctive traits of the five 
material of Elements of the world ;— 

The properties of Akas'a (ether) are sound, the sense of 
hearing, porosity and differentia evolution of the veins, 
ligaments etc. into their characterised species (Viviktatd.) 

Xif^^ ^^^'. ^"^ takes cognisance of sorrow, disease and death by its 
union with the body ( ^t ?T^UJ^ sjfjf^C ^^^\m g»iq 9gj^^ )• Hence 
the living frame together with the soul that ia said to inhabit it forms the 
subject-matter of Ayurvedic medical treatment, Ed. 



Chap. I J SARIRA STHANAM. 121 

The properties Vatya (etherin) are touch, the skin, all 
functional activities of the organism, throbbing of the 
whole body (Spandana) and lightness. The properties 
of Tejl (fire or heat) are form, the eyes, colours, heat, 
illumination, digestion, anger, generation of instanta- 
neous energy and valour. The properties of Apa (water 
or liquid) arc taste, the tongue, fluidity, heaviness, cold- 
ness, olioginousncss and semen. The properties or 
modifications of Prithivi (the earth matter or solid) 
are smell, the nose, embodiment and heaviness. 20. 

Of these the ether or Akasa abounds in attributes of 
the Sdttvika stamp, the Vayu or etherin in Rdjashika, 
the Teja in Sattvika and Rajashika, the water in S^ttvika 
and Tamashika and the earth in Tamasha attributes. 21. 

There are IVIemorable Verses :— These 

qualities are found to characterise and enter intothe*suc- 
cessive elements in the order of their enumeration. The 
specific attributes of these elements are manifest in the 
substances which are respectively originated from them. 
The term Prakriti or original nature connotes the eight 
categories (of Avyakta, Mahan, Ahamkara, and the five 
Tanmatras) and the rest of the twenty four fundamental 
principles are its modifications. The Furusha forms the 
twentyfifth principle. These twentyfive fundamental prin^ 
ciples of cosmogony have been dealt w^ith in the present 
treatise ^Salya-Tantram) as well as in the other treatise 
(Salaky-Tantram and Sankhya Philosophy). 22 — ■23. 

Thus ends the first Chapter of the S'arira Sihananin the Sus'ruta Samhita 
which deals with the science of Being in general. 



16 



CHAPTER II. 

Now we shall discourse on the Sariiam whicii 
treats of the purification of semen and cataminal 

fluid etc. (Sukra-^onita-^uddhirnama 
^ariram). i. 

A man is incapable ol begetting children, whose 
seminal fluid, affected by the aggravated Vayu, Pittam or 
Kapham, emits a cadaverous smell, or has acquired 
a clotted or shreddy character or which looks like 
putrid pus, or has become thin, or smells like urine 
or stool, 2. 

Deranged Semen : — Semen vitiated by the 
deranged Vayu acquires a (reddish-black) colour and 
gives rise to a pain (piercing and cutting etc.) which 
characterises the Vayu (at the time of being emitted). 
Similarly semen deranged by the Pittam gets a (yellowish 
or bluish etc.) colour and produces the specific pain 
(burning and sucking etc.) of the deranged Pittam 
(at the time of emission). Semen vitiated by the action 
of the deranged Kapham has a (white) colour and pro- 
duces the pain (itching sensation etc.) peculiar to the 
deranged Kapham (at the time of its outflow). The 
semen vitiated by blood is tinged with a bloody hue, 
produces all kinds of pain peculiar to the deranged 
Sonita (Pittam). The semen smells like a putrid corpse 
and is emitted in large quantities. The shreddy or 
clotted character of the fluid (Granthila) should be 
ascribed to the action of the deranged Vayu and 
Kapham. If vitiated by the action of the deranged 
Pittam and Kapham it looks like putrid pus (Puti- 
puya). Thin semen is caused by the deranged Vayu and 



Chap, II.] SARIRA STHANAM. ' 1 23 

Pittam as described before. A concerted action of the 
deranged Vayu, Pittam, and Kapham causes the semen 
to smell like urine or fecal matter. Of these, the 
cadaverously smelling, shreddy and clotted, putrid pus- 
like and thinned semen can be remedied and corrected 
only with the greatest difficulty ; while the one, having 
the smell of stool or urine, should be regarded as beyond 
cure. The remaining kinds arc curable. 3. 

Deranged Artavam :— The catamenial fluid 
(Artavam) of a woman vitiated by the deranged Vayu, 
Pittam, Kapham, or blood, either severally or in 
combination of two or more Doshas should be likewise 
considered as unfit for the purpose of fecundation. 
Vitiated catamenial fluid exhibits the characteristic 
colour and pain of the deranged Doshas or blood 
(underlying at its roots). Of the several kinds (of 
vitiated catamenial fluids) those which smell like a putrid 
corpse or fetid pus, or which is clotted, or is thin, or emits 
the smell of urine or fecal matter, should be deemed as 
being beyond remedy, the rest being amenable. 4. 

IVIemorable Verses :— The first three types 

of seminal derangements or defects should be corrected 
by an intelligent physican with an application of 
medicated oil etc. ^Sneha-karma), diaphoric measures 
etc* or uretheral injections ^Uttara-vasti). A medi- 
cated Ghrita prepared with a (decoction and Kalka 
of; Dhdtaki flowers, Khadira^ Dddima and Arjuna 
barks should be given to drink to a man whose 
semen em'ts a cadaverous smell (Kunapa\ As an alter- 
native, a medicated Ghrita prepared with (a decoction 
and levigated paste or Kalka of) the drugs forming the 
S^dlasdrddi group should be given to him. In a case of 

* The word " Adi " in the text inclutles emelic>, purgatives, Anuva- 
sanam and Aslhapanam meai^ures according to their specific Doshas. 



124 THE SUSIIRUTA SAMIIITA. [Chap II. 

clotted and shreddy semen (Granthi), the patient should 
be made to drink a medicated Ghrita prepared with a 
(decoction and Kalka of) S'athi, or with an alcaline solu- 
tion prepared from the ashes of the burnt P aids' ha wood. 
In the case of a pus-like appearance of the fluid the 
patient should be treated with the medicated Ghrita 
prepared with (a decoction and Kalka of) the drugs 
included within the groups of Parushakddi and Vatddi 
(Nyagrodhadi) Ganas, In a case of thin semen, 
measures laid down under the same head before, as w^ell 
as those to be hereafter described should be resorted to. 
Similarly a medicated Ghrita, prepared with (a de- 
coction and Kalka of) Chiti^akk roots ^ Ushira roots and 
Hingu, should be drunk in a case of the semen smelling 
like urine or fecal matter. In all cases of seminal 
disorders as well as in menstrual anomalies, Uttara- 
Vssti (uretheral or vaginal injection) should be made 
after having recourse to the application of medicated 
oil etc. (Sneha-karma\ purgatives, emetics, Asthapana 
and Anuvasana measures. 5 — 12 

Treatment of derang^ed Artava:— In 

all the four cases when the catamenial blood would be 
found to be vitiated (by the deranged Vayu, Pittam, 
Kaphah or Sonita), the preliminary remedial measures of 
the application of oil etc. purgatives etc. (Pancha-karma) 
should be first employed and then the following 
measures should be undertaken viz. application of 
Kalka, (levigated paste of drugs), Pichu (medicated 
plugs— pecharies etc.), Pathya (diet) and Achamaua 
^vashes with decoctions) as described under the treat- 
ment of Gyonoecological cases etc. Appearance of 
clots of blood (Granthi) in place of the healthy men- 
strual fluid would indicate, decoction or a pulverised 
compound of P^th^, Trushuna and Vrikshaka (Kutaja). 



Chap. II.] NIDANA STIIANAM. 125 

A decoction o^ B/iadras^'rifam'^ and Chandanam is indica- 
ted in the case when the menstrual fluid would smell like 
fetid pus, or contain marrow. The remedies described 
under the head of seminal disorders, should be likewise 
prescribed in cases of menstrual anomalies caused by 
the action of the deranged Vdyu, Pittam and Kaphah 
according to the requirements of each individual case 
under treatment. Sdli-rice, barley, wine and meat 
with cholagogue properties should be deemed as a 
wholesome diet in these cases. 13 — 16. 

Traits of pure and healthy semen 
and menstrual blood : — Semen which is 

transparent like crystal, fluid, glossy, sweet and emits 
the smell of honey ; or like oil or honey in appearance 
according to others, should be considered as healthy. 
The catamenial blood (Artava) which is red like the 
blood of a hare, or the washings of shellac and leaves 
no stains on cloths (which may be washed off by 
simply soaking them in water) should be considered as 
healthy. 17—18. 

Asrig'dara (Menorrhagia) :— An abnormal or 
excessive discharge of the menstrual blood (Artava), 
or its long persistence even after the wonted time, 
or its appearance at a premature or unnatural period 
(as well as contrarity in its colour or properties) is 
called Asrigdara. All types of the disease (Asrigdara) 
are attended with an aching in the limbs and a painful 
flow (of the catamenial fluid). In case of excessive 
hoemorrhage (from the uterus), symptoms such as weak- 
ness, vertigo, loss of consciousness, darkness of vision, 
or difficult breathing, thirst, burning (sensation of the 
body), delirium, palour, somnolence and other Vataja 

* Bhadras'riyam is 8'richandanam according to Dallana or white 
Sandal \vood according Gayadasj^. 



126 THE SUSHRUTA SAMHITA. [Chap. II. 

troubles (convulsion, hysteria etc.) may set in. A 
physician should treat a case of Asrigdara with 
measures and remedies as laid down under the head of 
R^kta-pittam (hoemorrhage) in a case when the 
patient is young (of sixteen years), careful in her diet, 
and the disease unattended with severe complica- 
tions. 19 -2t. 

Amcnorrhoe : -In a case of suppression of 
menstruation (Amenorrhoe) caused by the obstruction 
of the deranged Doshas (Vayu and Kapham) in the 
passage, the patient should be advised to take fish, 
Kulattha pulse, Masha pulse, Kanjikam fermented sour 
gru 1 etc.), Tila, wine (Sura), cow's urine, whey, half 
diluted Takra, curd and S^uktam for her diet. The 
symptoms and treatment of thin and scanty menstrua- 
tion have been described before. Still in such a case 
measures laid down for the treatment of Nashta-Rakta 
(amenorrhoe) may be adopted. Under a course of 
treatment described as before, the semen or the cata- 
menial blood of a person would be resorted to their 
healthy and normal condition. 22 — 23. 

A woman with (healthy) catamenial flow should 
forego the bed of her husband during the first three 
days of her uncleanness, as well as day sleep and 
colly rium. S'le shall not shed tears nor bathe, nor 
smear her person (with sandal paste etc.\ nor anoint 
her body, nor pare her nail, nor run, nor indulge in 
loud and excessive laughter and talk, nor should she 
hear loud noise, nor comb her hiir, nor expose herself 
to droughts, nor do any fatiguing work at all ; because 
if a woman sleeps in the day time (during the first three 
days of her period) her child of subsequent conception 
becomes sleepy or somnolent. The woman who applies 
collyrium along her eyelids (during those days), giv^es 



Cliap. il.] SARIRA STHANAM. 1 27 

birth to a blind child ; by shedding tears (during her 
period) a woman gives birth to a child of defective eye- 
sight ; by bathing or smearing her body (with sandal 
paste etc.) a miserable one ; by anointing her body 
a leper (Kushthi) ; by paring her nails a child with bad 
nails ; by running a restless one ; by indulging in ex- 
cessive laughter, a child with brown (S>ava) teeth or 
palate or tongue ; by excessive talking a garrulous 
child or one of incoherent speech ; by hearing loud 
sounds, a deaf child ; by combing her hair, a bald one ; 
whereas by exposure to the wind or by doing 
fatiguing work (during the first three days of her 
period) she gives birth to an insane child (conceived 
immediately after it >. Hence these acts (day sleep etc) 
arc to be avoided. 24 

Regimen to be observed in her 

menses : —A woman in her menses should lie down 
on a matress made of Kits' a blades (during the first three 
days of her uncleanness), should take her food from, her 
own blended palms or from earthen sauces, or from trays 
made of leaves. She shonld live on a course of Habishya 
diet and forswear during the time, even the sight of her 
husband. After this period, on the fourth day she should 
take a ceremonial ablution, put on a new (untorn) 
garment and ornaments and then visit her husband after 
having uttered the words of necessary benediction 25. 
Metrical Text :— A child conceived after the 
period resembles the man whom she first sees after 
ablution on the fourth day of her menses ; hence she 
should see none but her husband* at that time (so that 
the child may resemble his father). After that the 
priest shall perform the rites (Garbhadhana ceremony), 

* In the case of the hubband being absent at the time, she should look 
at the sun. 



128. THE SUSHRUTA SAMKtlTA. [Chap. it. 

to help the conception of a male child and after the 
ceremony a wise husband should observe the following 
rules of conduct. 26 — 27. 

Conduct of Husband :— A husbaud wish- 
ing to beget a son by his wife, should not visit her bed 
for a month (before the day of the next flow). Then on 
the fourth day of her uncleanness, he should anoint or 
lubricate his body with Ghrita, should partake of a food 
in the afternoon or evening composed of boiled S^ctli rice, 
milk and clarified butter, and then visit the bed of his 
wife The wife also, in her tern, should observe a similar 
vow of sexual abstinence (Brahma-charini) for a month 
before that day on which she should anoint or lubricate 
her body with oil, partake of food largely composed 
of oil and Masha pulse, and then meet her husband 
at night. The husband then having uttered the appro- 
priate Veda Mantras and having awakened confidence 
in the wife, should go unto her on the fourth, sixth, 
eighth, tenth or on the twelfth night of her menses for 
the progenation of a male child. 28. 

IVIetrical Text ;— A visit to the wife on any 
of these nights leads to the continual increase of the 
wealth, progeny, and the duration of the husband's life. 
On the other hand, a visit to one's wife on the fifth, 
seventh, ninth, or eleventh day of her flow leads to the 
conception of a female child The thirteenth and the 
remaining days (till the next course) are condemned 
as regards intercourse. 29—30 

Prohibited Period etc. :— A going unto 

one's wife on the first day of her monthly course tends to 
shorten one's life and a child born of the act dies imme- 
diately after its delivery. The same result is produced 
by a visit on the secontl day, or the child dies lying-in 
locm i.e. ten days of its birth ; A visit on the third day 



Chap, n.j SARIRA STHANAM. 1 29 

leads to the child's being deformed and short-lived. A 
child which is the fruit of a visit on the fourth day lives 
long, will be well developed and remain in the full vigour 
of health. The semen cast in the womb of a woman 
during the continuance of her monthly flow does not 
become fruitful because it is carried back and flows out 
in the same manner as a thing thrown into a stream does 
not go against but is carried away with the current. 
Hence a husband should foreswear the company of his 
wife during the first three days of her uncleanness, when 
she also should observe a vow of sexual abstinence ; the 
husband should not visit his wife within the month 'after 
the twelfth day of her menses). 31. 

After the impregnation on any of these nights, three 
or four drops (of the expressed juice) of any of the 
following drugs such as Lakshand, Vata-S'unga! , 
S'ahadevd or Vis'vadevd, mixed with milk should be 
poured into the right nostril of the enceinte for the 
conception of a male child and care should be taken 
that she does not spit it away. 32, 

lYIetrical Text :— A co-ordination of the four 
factors of menstrual period (Ritu), healthy womb 
(Kshetra), nutrient liquid le. chyle of digested food 
(Ambu), healthy semen (Vija) and the proper observance 
of the rules is necessary for the conception and develop- 
ment of a healthy child just as the proper season 
(Ritu), good soil (Kshetra), water (containing nutrient 
matter) and vigorous seeds (Vija) together with proper 
care, help the germination of strong and undiseased 
sprouts. A child which is the fruit of such conception 
is destined to be beautiful, of vigorous health, generous, 
long-lived, virtuous, attached to the good of its 
parents and capable of discharging its parental obliga- 
tions. 33. 

17 



130 THE SUSHRUTA SAMHItA. [Chap. tl. 

Causes of different colours of the 
Child:— The fiery principle (Teja-dhaitu) of the 

organism, which is the originator of all colours of the 
skin (complexion), happening to mix largely with the 
watery principle of the body at the time of conception, 
serves to make the child a fair complexioned one 
(Gaura-varna) ; mixed with a large quantity of the 
earth principle (Kshiti) of the body, it makes the chiid a 
dark complexioned one (Krishna-varna). In combi- 
nation with a large quantity of earth and ethereal 
principles of the organism, it imparts a dusky (Krishna- 
syama) complexion (to the full developed fcetus). A 
similar combination of watery and ethereal principles 
serves to make the child dusky yellow (Gaura-syama). 
Others on the contrary aver that the complexion of the 
child is determined by the colours of the food taken 
by its mother during the period of gestation. 34. 

A child is born blind in the failure of the fiery 
principle (Teja-dhatu) of the organism in reaching the 
region of its still undeveloped eyes (part — where the 
eyes would be) ; so also a penetration by the same 
(Teja-dhatu) into its blood accounts for the blood-shot 
eyes of the child. Entered into the Pittam it makes 
the child a yellow-pupiled one (Pingalaksha). Entered 
into its bodily Kapham it makes it a white-eyed body 
and mixed with its bodily Viyu, a child of defective 
eyesight. 35. 

Memorable verses:— As a lump of con- 

densed clarified butter melts and expands if placed by 
the side of a fire, so the ovum (Artava) of a woman is dis- 
lodged and glides away in contact with an adult male*. 

* Sus'iula's theory is that ovulation occurs about the same time as 
menstruation and rather initiates the latter, and the shed ova are washed 
out wiih the menstrual flow, hence there is a possibility of conception on 



Chap. II.] SARIRA STHANAM. I31 

A seed divided into two by the deranged Vayu within 
the (cavity of the) uterus (Kukshi) gives rise to the birth 
of twins, conditioned by the good or evil deeds of their 
prior existence * A child born of scanty paternal 
sperm becomes an Asekya and feels no sexual desire 
(erection) without previously (sucking the genitals and) 
drinking the semen of another man. A child begotten 
in a sordid vagina is called a Sougandhika, whose 
organ does not respond to the sexual desire without 
smelling the genitals of others. The man who first be- 
comes a passive member of an act of sodomy and then 
again commits sodomy with the woman (he visits) is 
called a Kumbhika (or Guda-yoni and is included 
within the category of a Kliva). 2>^ — 40. 

The man who cannot copulate with a woman without 
previously seeing the sexual intercourse of another couple 
is called Irshaka. A child born of an act of fecund- 
ation foolishly or ignorantly effected during the menses 
of its mother by its progenitor by holding her on his 
bosom during the act is called a Shanda and invariably 
exhibits effeminate traits in his character. A daughter 
born of a woman riding on her husband during the act 
of sexual intercourse will develop masculine traits in 
her character. 41 — 43. 

connexion during the period of flow. But when the menstruation 
stops of itself by the end of the third day, it also indicates that 
ovulation has ceased and no ovum is left to be fertilized, hence the 
question arises how can there be conception then on connexion on the 
fourth day and thereafter ? The explanation (as in the following verse) 
is that the ovulating organ though quiescent at the time is again 
stimulated to activity by intercourse with a male and new ova are shed 
which are ready to be fertilized by the semen. — Ed. 

* Gayi interprets the term **Dharmetara" to mean evil deeds (other 
than good) and quotes verses from S'rutis, S'mritis and Tantras on ex- 
piations of sin in support of his view. 



j?,2 THE SUSHRUTA SAMHITA [Chap. II. 



w' 



Semen is developed in the four types of Kliva 
known as Asekya, Sougandhika, Kumbhikaand Irshaka, 
whereas a Shanda is devoid of that fluid (Sukra). 
The semen carrying ducts of an Asekya etc. are ex- 
panded by the drinking of the semen as above described 
which helps the erection of his reproductive organ. 44-45 

The conduce and character of a child and its incli- 
nation to particular dietary are determined by those of 
its parents during the act of fecundation. A boneless 
{i, e. with cartilaginous bones) monstrosity is the 
outcome of the sexual act in which both the parties arc 
female and their Sukra (sexual secretion) unite some 
how or other in the womb of one of them. Fecundation 
may take place in the womb of a woman, dreaming of 
sexual intercourse in the night of her menstrual ablution. 
The local Vayu carries the dislodged ovum into the uterus 
and exhibits symptoms of pregnancy, which develop 
month after month till the full period of gestation. The 
offspring of such a conception is a Kalala (a thin bone- 
less jelly-like mass) on account of the absence of the 
paternal elements* in its development. Such monstro- 
sities as serpents, scorpions, or gourd shaped foetus 
delivered from the womb of a woman should be ascribed 
as the effects of deadly sins. 46-49. 

The child of a mother whose wishes are not honoured 
and gratified during pregnancy stands in danger of being 
bom palmless, hunchbacked, lame, dumb or nasal 
voiced through the deranged condition of the Vdyu of 
its mother's body. The malformation of a child in the 
womb should be ascribed to the atheism of its parents, 
or to the effects of their misdeeds in a prior existence, or 

* Hair, beard, nails, teeth, arteries, veins, ligaments and semen are 
called paternal elements inasmuch as these are said to be inherited by 
tlje child from its fj^ther 



Chap. II.] SARIRA STHANAM. I33 

to the aggravated condition of the Vayii, Pittam and 
Kapham. 50 — 51. 

A foetus in uterus does not excrete faeces or urine, 
owing to the scantiness of the fecal matter, etc , in its 
intestines and also to the obstruction and consequently 
lessened admission of the Vayu into its lower bowels. 
A child in the womb does not cry inasmuch as its 
mouth remains covered with the sheath of the placenta 
i.e. foetal membranes (Yarau) and its throat is stuffed with 
Kapham. The processes of respiration, sleeping and 
movement of the foetus in the womb are effected through 
those of its mother. 52 — 53. 

The adjustment of the different limbs and organs 
of the body of a child in the womb at their proper 
places, the non-development of hair on its palms and soles 
and the subsequent cutting and falling off of its teeth are 
spontaneously effected according to the laws of nature 
after the model of its own species. An honest, pious, 
erudite man, who has acquired a vast knowledge of 
the Sastras in his prior existence, becomes largely 
possessed of mental traits of the Sdttvika stamp in 
this life too and also remembers his prior births 
(Jatismara). Acts similar to those, which a man 
performs in a prior existence, overtake him also in the 
next. Similarly the traits and the temperament which 
he had developed in a previous existence are likewise 
sure to be patent in the next. 54—55- 

Thus ends the second Chapter of the S'arira Sthanam in ihe Sus'ruta 
Samhila which treats of the purification of sperm and ovum. 



CHAPTER III. 

Now we shall discourse on the Sariram which treats of 

pregnancy, etc. (Garbha Yakrant i ^ari ram), i. 

The male reproductive element (Sukra) is endowed 
with Soma-guna (i.e , thermolytic properties) the female 
element Artava) presents the opposite property and is 
therefore Agni-guna (i e., thermogenetic properties). 
The principles of earth, water, fire:, air and ether are also 
present in men in their subtile forms and contribute to 
the formation of the material parts by their molecular 
adjustment in the way of supplying nutrition and in 
way of the adding to their bulk. 2. 

Combination of Self with the im- 
pregnated matter :— The local Vdyu (nerve- 
force) heightens or aggravates the heat generated by 
the friction of the sexual organs in an act of copula- 
tion. The Vdyu and heat thus aggravated tend to dis- 
lodge the semen from its sac or receptacle in a man 
which enters into the uterus of a woman through the 
vaginal canal and there it mixes with the ovum 
(Artavam) dislodged and secreted by similar causes. 
The combined ovum and semen are subsequently con- 
fined in the uterus vGarbhclsaya). After that, He who 
is known by the epithet; of Self-conscious, impressioner 
(creator of sensations and perceptions), toucher, smeller, 
seer, hearer, taster. Self or Ego, creator, wanderer, wit- 
ness, ordainer, speaker, though eternal, unmanifested 
and incomprehensible in his real nature, takes hold of 
the five subtile or essential material principles contributed 
by the united impregnating matter, assumes a subtile 
shape throughout, marked by the three fundamental 



Chap. III.] SARIRA STHANAM. 1 35 

qualities of Sattva, Rajas and Tamas, and led away by 
the Vayu, lies confined in the uterus to be subsequently 
evolved out in the shape of a god, animal, or monster, 
as determined by his acts in the former existence. 3. 

Factors which determine sex :— The 

birth of a male-child marks the preponderance of semen 
over the ovum (in its conception) ; the birth of a 
daughter shows the preponderance of the maternal ele- 
ment. A child of no-sex (hermaphrodite) is the product 
when ovum and sperm are equal (in their quality and 
quantity). The first twelve nights after the cessation 
of the flow should be deemed as the proper period for 
conception, as being the time during which the ova are 
secreted. Certain authorities hold that there are women 
who never menstruate to all appearances 4 — 5. 

IVlemorable verses :— The face of a woman 
(lit : a woman of undetected menstruation) becomes 
full and lively. A moist and clumsy deposit is found 
on the body, face, teeth and gums. She feels a 
desire for sexual intercourse and speaks sweet words. 
Her eyes, hair, and belly droop down. A sort of 
distinct throbbing is felt in her aims, thighs, mammse, 
umbilicus, perineum and buttocks. Her sexual desire 
grows intense and prominent, and its gratification gives 
her utmost joy and pleasure. These symptoms will at 
once indicate that a woman has menstruated (inter- 
nally). 6. 

Just as the petals of a full blown lotus flower are 
gathered up during the night, so the uterus (Yoni) of a 
woman is folded up {i. e., os of the uterus is closed) after 
the lapse of the menstrual period {ie. fifteen days from the 
date of the flow). The menstrual flow, accumulated in 
the course of a month, is led in time by the local Vayu 
through its specific duct (Dhamani) into the mouth of 



136 THE SUSHRUTA SAMIIITA. [Ch&p. III. 

the uterus (Yonij whence it flows out odourless and 
blackish, 7. 

Period of IVIenstruation :— The process 

(menstruation) commences at the twelfth year, flowing 
once in every month, and continues till the fiftieth* year 
when it disappears with the sensible decay of the body. 8 

A visit"!- to one's wife on even days during the cata- 
menial period (twelve days in all from the cessation of 
the flow) leads to the conception of a male child while 
an intercourse on odd days results in the birth of a 
daughter. Hence a man, seeking a male-issue, should 
approach his wife for the purpose in a clean body and 
with a quiet and calm spirit on an even date. 9. 

A sense of fatigue and physical languor, thirst, 
lassitude and weariness in the thighs, suppression of the 
flow of semen and menstrual secretion (Sukra and 
Sonita) out of the uterus (Yoni), and throbbing in the 
organ /Rafter coition) are symptoms of a recent fecun- 
dation. lO. 

Signs of Pregnancy-(M. T. :— A black 

rash (areola) around the nipples of the mammae, the 
rising appearance of a row of hair (as far as the umbilicus), 
contractions of the eye-wings, sudden vomitings, nausea 
which does not abate even on smelling perfumes, water- 

* Some are of opinion that the menstruation continues up to the 
sixtieth year. 

t According to Videha, menstrual secretion flows less on even 
days, hence a son is born if the sexual intercourse be made on those 
days ; whereas menstrual secretion becomes more on odd days, so a 
daughter is born if the intercourse be made on odd days. 

According to Bhoja, a son is born from intercourse on even days and 
a daughter is born from that on odd days. The birth of a male issue is 
due to the preponderance of semen virile and that of a female sex is due 
to the preponderance of menstrual secretion. If both the secretions be 
equal (in quality and quantity) a hermaphrodite is issued. 



Chap. III.] SARIRA STHANAM. 



13; 



brash, and a sense of general lassitude are the indications 
of pregnancy, ri. 

Prohibited conducts during gesta- 
tion : ^Immediately on the ascertainment of her 
pregnancy, a woman should avoid all kinds of physical 
labour, sexual intercourse, fasting, causes of emaciation 
of the body, day-sleep, keeping of late hours, indulgence 
in grief, fright, journey by carriage or in any kind of 
conveyance, sitting on her haunches, excessive appli- 
cation of Sneha-karmas etc., and venesection at an 
improper time {i.e , after the eighth month of gestation), 
and voluntary retention of any natural urging of the 
body. 12. 

IVIetrical Text :— The child in the womb feels 
pain in the same part of its body as the one in which 
its mother feels any ; whether this (pain) may be from 
an injury or through the effect of any deranged morbific 
principle (Dosha) of her organism. 13. 

Development of the Foetus:— In the first 

month of gestation a gelatinous substance is only 
formed (in the womb) ; the molecules of the primary 
elements (Mahabhuta — air, fire, earth, water, and ether) 
being acted upon by cold (Kapham\ heat (Pittam) and 
air (Vdyu or nerve-force) are condensed in the second 
month. A lump-like appearance (of that confused 
matter) indicates the male-sex (of the embryo). An 
elongated-like shape of the matter denotes that the 
foetus belong to the opposite sex ; whereas its tumour- 
like shape (like a Salmali-bud) predicts the absence of 
any sex {i e, a hermaphrodite), In the third month, 
five lump-like protuberances appear at the places where 
the five organs —namely the two hands, two legs and the 
head — would be and the minor limbs and members of 
the body are formed in the shape of extremely small 



138 THE SUSHRUTA SAMHITA. [Chap. III. 

papillae. In the fourth month all the limbs and organs 
(of the body of the embryo) become more potent and 
the foetus is endowed with consciousness owing to the 
formation of viscus of the heart. As heart is the seat 
of consciousness, so a? the heart becomes potent, it is 
endowed with consciousness and hence it expresses its 
desire for things of taste, smell etc. (through the 
loneincfs of its mother). The enciente is called double- 
hearted (Dauhrida) at the time, whose wishes and 
desires — not being honoured and gratified — lead to the 
birth of a paralysed, hump-backed, crooked -armed, 
lame, dwarfed, defect-eyed, and a blind child. Hence 
the desires of the enciente should be gratified, which 
would ensure the birth of a strong, vigorous and long- 
lived son. 14. 

IVlemorable Verses :— A physician should 

cause the longings of a pregnant woman (Dauhrida) 
to be gratified inasmuch as such gratifications would 
alleviate the discomforts of gestation ; her desires being 
fulfilled ensure the birth of a strong, long-lived, and 
virtuous son. A non-fulfilment of her desires during 
pregnancy, proves injurious both to her child and her 
ownself. A non-gratification of any sensual enjoy- 
ment by its mother ;Dauhrida) during gestation tends 
to painfully afTect the particular sense-organ of the 
child. 

Longings and its effects during 

pregnancy : — An enciente longing for a royal 
interview during her gestation (fourth month) gives 
birth of a child, who is sure to be rich and to hold a 
high position in life Her longing for fine silks, 
clothes, ornaments etc. indicates the birth of a beauti- 
ful child of aesthetic taste. The birth of a pious and 
self-controlled child is indicated by its mother's longing 



Chap. III.] SARIRA STHANAM, 



39 



for a visit to a hermitage. The desire of a pregnant 
woman to see a divine image or an idol, predicts the 
birth of a child in her womb who would grace the council 
of an august assembly in life. Similarly, a desire to 
see a savage animal on the part of a pregnant woman 
signifies the presence of a child of savage and cruel 
temperament in her womb. A desire for the flesh of a 
Godha indicates the presence of a sleepy, drowsy person 
in her womb who would be tenaciously fond of good 
things in life. Similarly a longing for beef on the 
part of the mother (during gestation) indicates the birth 
of a strong and vigorous child capable of sustaining 
any amount of fatigue and physical pain A longing 
for bufifalo-meat of the mother indicates the birth of a 
hairy, valiant and red-eyed child (in her womb); a 
longing for boar-flesh indicates the birth of a drowsy 
child though valiant ; a longing for venison indicates 
that of an energetic, determined and sylvan-habited 
child ; a longing for Srimara-meat indicates that of a 
distracted person ; a longing for the flesh of Tittira 
bird indicates that of a child of timid disposition ; 
whereas a desire on the part of an enciente for the 
flesh of any particular animal indicates that the child 
in the womb would be of such stature and would 
develop such traits of character in life as are peculiar 
to that animal. The desires of a woman during her 
pregnancy are determined by ordained fate and effects 
of the acts of the child in its prior existence (that are to 
be happened during the present life). 15. 

Development of the FcBtus s— In the 

fifth month the foetus is endowed with mind (Manah^ 
and wakes up from the sleep of its sub-conscious exis- 
tence. In the sixth month cognition (Buddhi) comes 
in. In the seventh month all the limbs and members 



I40 THE SUSHRUTA SAMHITA. [Chap. III. 

of its body are more markedly developed. The Ojo- 
dhdtu (in the heart of the foetus) does not remain silent 
in the eighth month * A child born at that time (eighth 
month) dies for want of Ojo-dhatu soon after its birth, 
a fact which may be equally ascribed to the agency of 
the malignant monsters. Hence (in the eighth month of 
gestation) offerings of meat should be made to the demons 
and monsters (for the safe continuance of the child). 
The parturition takes place either in the ninth, tenth, 
eleventh or twelfth month of conception, otherwise 
something wrong with the foetus should be appre- 
hended. i6. 

The umbilical chord (Nadi) of the foetus is found to 
be attached to the cavity of the vein or artery of its 
maternal part through which the essence of lymph-chyle 
(Rasa) produced from the assimilated food of the 
mother, enters into its organism and fastens its growth 
and development, (a fact which may be understood from 
the analogy of percolation or transudation of blood). 
Immediately after the completion of the process of 
fecundation, the vessels (Dhamani) of its maternal body 
which carry the lymph-chyle (Rasa) and run laterally and 
longitudinally in all directions through it, tend to foster 
the foetus with their own transudation all through its 
continuance in the womb. 17. 

Different opinions on the formation 
of the foetal body :— Saunaka says that 
probably the head of the foetus is first developed 
since head is the only organ that makes the functions 
of all other organs possible. Kritaviryya says, it is 
the heart that is first developed since heart is the seat 
of Manah and Buddhi (mind and intellect). The son of 

* Sometimes it passes from the body of the child to that of the 
mother and vice versa. 



Chap. III.] SARIRA STHANAM. I4I 

Para'sara says that the development of the umbilical re- 
gion of foetus must necessarily precede (that of any other 
part of its body) inasmuch as it is through umbilical 
chord that an embryo draws its substance from mother's 
body. Matrkandeya says that the hands and feet of a 
fcetus are first te be developed since they are the only 
means of movements in the womb. Subhuti Gautama 
says that the development of the trunk is the earliest in 
point of time since all other limbs and organs lie solder- 
ed to and imbedded in that part of the body. But all 
these are not really the fact. Dhanvantari holds that the 
development of all the parts of the body of an embryo 
goes on simultaneously ; and they can not be perceived 
or detected in their earlier stages of development in the 
womb owing to their extremely attenuated size like a 
mango fruit or sprouts of bamboo. As the stone, marrow, 
pith etc. of a ripe and matured mango-fruit or the 
sprouts of bamboo, cannot be separately perceived in 
the earlier stage of their growth but are quite distin- 
guishable in the course of their development, likewise 
in the early stage of pregnancy the limbs and organs of 
the body (foetus) are not perceptible for their extremely 
attenuated stage but become potent (and therefore they 
are distinctly perceived) in the course of time for their 
development. 18. 

Factors respectively supplied by the 
paternal and maternal elements :-Now 

we shall describe the parts and principles of the 
body of a foetus which are respectively contributed by 
the paternal element, maternal factor, the serum 
(Rasaja),the soul (Atmaja), the natural (Sattvaja) and the 
innate physiological conditions (Satmyaja). The hairs 
of the head and body, beard and moustaches, bones, 
nails, teeth, veins (Sira), nerves, arteries (Dhamani), 



142 THE SUSHRUTA SAMHITA. [Chap. III^ 

semen and all the steady and hard substances (in 
the organism of a child) are contributed by the 
paternal element in the conception Pitraja ; whereas 
flesh, blood, fat, marrow, heart, umbilicus, liver, spleen, 
intestines, anus (Guda) and all other soft matters in 
the body owe their origin to the maternal element 
(Matrija) ; strength, complexion, growth, rotundity and 
decay of the body are due to the serum (Rasaja\ 
The sensual organs, conciousness, knowledge, wisdom, 
duration of life (longivlty), pleasure and pain etc. are 
the outcome of the spiritual element in man (Atmaja). 
We shall describe the Sattvaja features of the body in 
the next chapter. Valour, healthfulness, strength, glow 
and memory are the products of a child naturally 
born with physiological conditions of the parents 
(Sdtmyaja). 19. 

Signs of male and female concep- 
tion : — An enciente, in whose right mammae the milk 
is first detected, who first lifts up her right leg at the 
time of locomotion, whose right eye looks larger, or 
who evinces a longing largely for things of masculine 
names, dreams of having received lotus flowers (red 
and white), Utpala, Kumuda, Amrataka, or flowers of 
such masculine denomination in her sleep, or the glow 
of whose face becomes brighter during pregnancy, may 
be expected to give birth to a male child; whereas 
the birth of a daughter or a female child should be 
pre-assumed from the contriety of the foregoing indi- 
cations. An enciente whose sides become raised and 
the forepart of whose abdomen is found to bulge out 
will give birth to a sex-less (hermaphrodite) child. An 
enciente, the middle part of whose abdomen becomes 
sunk or divided in the middle like a leather-bag, will 
give birth to a twin. 20. 



i 



Chfip. ni-3 SARIRA STHANAM. I43 

lYIemorable verses :— Those women who 
are devout in their worship of the gods and the 
BrAhmins and cherish a clean soul in a clean body 
during pregnancy are sure to be blest with good, 
virtuous and generous children ; whereas a contrary 
conduct during the period is sure to be attended 
with contrary fruits. The development of the limbs 
and the members etc. of a foetus in the womb is natural 
and spontaneous, and the qualities and conditions 
which mark these organs are determined by the acts 
of the child which arc anterior to its genesis and wcro 
done in its prior existence. 21-22. 

Thus ends the third Chapter of the S'arira Sihiinain in the Su 'ru(a 
Samhita which treats of the generation and pregnancy. 



CHAPTEE IV. 

Now we shall discourse on the Sariram which 
treats of the development of a fcetus in the womb, 
as well as of the factors which contribute to the growth 
of its different bodily organs and principles (Garbha- 

Vyakaranam-^gfriram). i. 

The Pittam (fiery or thermogenic) and Sleshma 
(lunar principles of the body, the bodily Vayu, the three 
primary qualities of Sattva, Rajas, and Tamas (adhesion, 
cohesion and disintegration), the five sense organs, and 
the Self (Karma-Purusha) are the preserver of the life 
(Prdnah) of the Fcetus. 2. 

Folds of Skin : —Seven folds or layers of cover- 
ing (Tvaka — skin) are formed and deposited on the 
rapidly transforming product of the combination of 
(semen) Sukra and Sonita (fertilized ovum) which 
have been thus charged with the individual Soul 
or Self in the same manner as layers (of cream) are 
formed and deposited on the surface of (boiling) milk. 
Of these the first fold or layer is called Avabha'sini 
(reflecting) as it serves to reflect all colours and is cap- 
able of being tinged with the hues of all the five mate- 
rial principles of the body. The thickness of this fold 
measures eighteen-twentieth of a Vrihi^ (rice grain) and 
it is the seat of skin diseases, such as Sidhma, Padma- 

* The complexion of a person is due to this first layer ; and as the 
colour of an opaque body is due to the rays that are reflected from its 
surface, this layer is rightly named Avabba^'ini or reflecting layer. 

** The text runs "Vriherashtadashabhaga," which means eighteen (or 
so mnny) parts of a Vrihi ; and Dalian comments that "Vrihi" stands for 
a measure equal to the twentieth division of a Vrihi or rice grain. 



Chap, IV.] SARIRA STHANAM. I45 

kantaka etc. The second fold (from the surface) is 
called Lohitai ; it measures a sixteen-twentieth of a 
Vrihi and is the seat of such (cutaneous affections; as 
Tilakilaka, Nyachcha and Vyanga etc. The third fold 
or layer is called S'/^ti which measures in thick- 
ness, a twelve-twentieth of a Vrihi, and forms the seat 
of such diseases as Aj.igalli, Charmadala, and Mas'aka 
etc. The fourth fold or layer is called Tstmrak 
measuring an eight-twentieth of a Vrihi and forms 
the seat of such diseases as the various kinds of Kilasa 
and Kushtha etc. The fifth fold or layer is called 
Vedini, measuring in thickness a five-twentieth of a 
Vrihi and forms the seat of Kushtha, Visarpa, etc. The 
sixth fold or layer is called Rohini, which is of equal 
thickness as a Vrihi (grain), and is the seat of Granthi, 
Apachi, Arvuda, SHpada and Gala-ganda etc. The 
seventh fold or layer is called Matasa-dhara( twice a 
Vrihi in thickness and is the seat of Bhagandara, 
Vidradhi, and Ars'a etc. These dimensions should be 
understood to hold good of the skin of the fleshy parts 
of the body, and not of the skin on the forehead, or 
about the tips of the fingers, inasmuch as there is a 
surgical dictum to the effect that an incision as deep as 
the thickness of the thumb may be made into the 
region of the abdomen with the help of a Vrihi-mukha 
(instrument). 3. 

The Kala(s too number seven in all and are situated 
at the extreme borders (forming encasement and support) 
of the different fundamental principles (Dhatus) of the 
organism. 4. 

Memorable Verses : — As the duramen or 
core of a piece of wood or stem becomes exposed to view 
by cutting into it, so the root principles (Dha'tus) of the 
body may be seen by removing the successive layers or 

19 



146 THE SUSHRUTA SAMlilTA. Chap. IV. J 

tissues of its flesh. These Kalds are extensively supplied 
with Snayus (fibrous tissues), bathed in mucous, and 
encased in a membranous covering. 5-6. 

lYIansadhara-Kala: - Of these Kalas,the first 
is named Ma^nsadhara (fascia), in the contained flesh 
(bodily substance of the Kala) of the Sira (veins), Snayu 
(fibrous tissues), Dhamani (arteiies) and other Srotas 
(channels; are found to spread and branch out. 7. 

lYlemorable Verse : — As the roots and stems 
of a lotus plant respectively situated in the ooze and 
water (of a tank;, do si.nultaneously grow and expand, 
so the veins etc situated in the flesh, grow and 
ramify. 8. 

Raktadhara- Kala : -The second Kald is 

called Raktat-dharai (Vascular tissue of the blood vessels 
etc.). The blood is contained in these inside the flesh 
and specially in the veins (Sira) and in such viscera of 
the body as the liver and spleen. 9. 

IVIemorable Verse:— As a piant containing 
latex in its tissues, when injured or pricked, exudes 
milky juice, so blood oozes out instantaneously on the 
flesh of the body (supplied with the Raktadhara-kala) 
being injured. 10. 

lYIedadhara-Kala :— The third Kald is called 
Medadharai (adipose tissue). Meda (fat) is present (chiefly) 
in the abdomen of all animals, as well as in the cartila- 
ges (small bones). The fatty substance present in large 
bones is called Majjai (marrow), ir. 

lYIemorable Verse :— Marrow is found inside 
large bones, whereas a substance similar in appearance 
and found inside other bony structures (cartilages) should 
be considered as Meda, mixed with blood. The fats, 
present in purely muscular structures, go by the name 
of Vassi (muscle-fat). 12-13. 



[Chap. IV. SARIRA STHANAM. 



147 



dleshmsLdhar^C-Kala :— The fourth Kala is 
called Sleshmaidharai (Synovial tissues) and is present 
about all the bone-joints of animals. 14. 

IVIemorable Verse : -As a wheel easily turns 
upon a well greased axle, so the joints moistened by the 
mucous (Sleshma) contained in these sacs admit of easy 
movements, i^. 

Purishadhara-Kala :— The fifth kala is 

called Purishadharai and being situated in the Kostha 
(abdomen) serves to separate the faecal refuse in the 
(Pakvasaya) lower gut (from other ingested matters). 16. 

Memorable Verse : —This Kala extends about 
the liver, upper and lower intestines and other abdominal 
viscera and keeps the foeces in the lower intestines (Un- 
dukam) separate and hence is called Maladhara-kald 17. 

Pittadhara-Kala:— The sixth Kald is called 
Pittapharat-kalSL ; it holds (the chyme derived from) the 
four kinds of solid and liquid foods (in the Pitta-sthanam 
or biliary region; propelled from the stomach (Amds'aya 
or Grahani-Nadi) and on its way to the (Pakasaya) 
intestines (for the proper action of the digestive juices 
upon it) 18. 

IVIemorable Verse :— The four kinds of food, 

viz. those that are chewed, swallowed, drunk, or licked, 
and brought into the intestines (Kostha) of a man, are 
digested in proper time through the heating agency 
(action) of the Pittam 19. 

^Ukradhara-Kala :-Thc seventh Kala is 
called S'lkradharsi (semen-bearing), which extends 
throughout the entire body of all living creatures. 20. 

Memorable Verse : -The physician should 

know that like fat (Sarpi) in the milk, or sugar in the 
expressed juice of sugar-cane, the (seat of) semen is co- 
extensive with the whole organism of a man (or animal). 



148 THE SUSHRUTA SAMHITA. [Chap. IV. 

The semen passes through the ducts situated about two 
fingers' breadth on either side (vas deferens) and just 
below the neck of the bladder and finally flows out 
through the canal. The semen of a man during an act of 
sexual intercourse with a female under exhilaration 
comes down from all parts of his body owiiig to the 
extreme excitement (engendered by the act). 21-33. 

The orifices of the Artava— carrying channels (vessels 
of the uterine mucosa) of a pregnant woman are ob- 
structed by the foetus during pregnancy and hence there 
is no show of menses (during gestation). The menstrual 
blood thus obstructed in its downward course ascends 
upwards ; a part of it accumulates and goes to the 
formation of placenta (Apara' , while the rest ascends 
higher up and reaches the breasts ; this is the reason 
why the breasts of a pregnant woman become full and 
plump. 24. 

The spleen and liver of the foetus are formed out 
of blood ; the lungs are made of the froth of the 
blood ; and the Unduka or faecal receptacle, of the refuge 
matter (Mala) of the blood. 25, 

Metrical Texts :— The intestines (Antra), the 
bladder (Vasti), and the anus (Guda) of the foetus are 
formed out of the essence of the blood and Kapham, 
baked by the Pittam into which VAyu enters as well. 
As fire fed by draughts of air refines the dregs of 
golden ore and transforms it into pure metal, so blood 
and Kapham acted upon by the heat of the Pittam 
are transformed into the shape of the intestines etc. 
in the abdomen. The tongue is made of the essence 
of the flesh, blood and Kapham. The Vdyu, com- 
bined with heat (Pittam) in adequate proportion, rends 
through the internal channels into the flesh and trans- 
forms them into muscles (Pesi). The Vdyu, by taking off 



Chap. IV.] SARIRA STHANAM. 149 

the oily principles of fat (Meda), transforms them into 
(Sirat' and (fibrous tissues) Sna^yu,the underbaked (Mridu) 
ones being converted into the Sir^ and the overbaked 
(Kshara) ones into the Sndyu. The internal cavities 
(As'ayas) of the body mark the spots or regions where the 
Vayu had constantly stayed in its embryo stage. 26-29. 
The kidneys (Vrikkas) are made out of the essence 
of the blood and fat. The testes are formed out of the 
essence of the blood, flesh, Kapham and fat. The heart 
is formed out of the essence of blood and Kapham ; 
and the vessels (Dhamanis) carrying the vital principles 
of the body are attached to it (heart). The spleen and the 
lungs are situated below and beneath the heart on the 
left side, and the liver and Kloma (Pancreas ?) below 

and beneath it (heart) on the right. The heart is the 
special seat of consciousness (ChetaiiS^) in all creatures. 

Sleep sets in when this viscus heart) of a person becomes 

enveloped by the effects of the Tamas (principles of 

illusion or nescience). 30-31. 

IVIemorable Verse S— The heart which is of 

the shape of a lotus bud hangs with its apex downward, 

folding itself up during sleep and expanding with the 

return of wakening or consciousness. 32. 

Sleep and its virtues :— Sleep is the illu- 
sive energy of God ^lit. — the all-pervading deity; and 
naturally has its sway over all created beings. The 
kind of sleep which sets in when the sensation-carrying 
channels iSn^yu) of the body are choked by Sleshma, 
which abounds in the quality of Tamas, is known as 
Tatmasi-nidrai. It is this sleep which produces uncon- 
sciousness at the time of dissolution or death. A man 
of Tatrnxsika-temperament sleeps both in the day and 
night ; one of the Ra^asika-temperament sleeps either in 
the day or in the night ; while sleep never visits the 



T50 THE SUSIIRUTA SAMHITA. Chap. IV.] 

eyelids of a man of Sa^ttvika-temperament before mid- 
night. Persons with enfeebled Kapham and aggra- 
vated Vayu, or suffering from bodily and mental troubles, 
get little sleep, and if at all, their sleep is of the Vaika- 
rika or delirious type {i.e. much disturbed)* 33-34. 

IVIemorabIC Verses : -O SusVuta ! the heart is 
said to be the primary seat of consciousness (Chetan^) in 
the animated beings. Sleep overcomes a man whenever 
the heart is enveloped in the illusive effects of Tamas. 
Sleep is the offspring of Tamas and it is the quality of 
Sattvam that brings on awakening. This is the funda- 
mental law of Nature. The self-conscious individuality 
(Self), ensconced in the material frame of man which 
is composed of the five material elements, recollects 
through the agency of the mind (Manah), which abounds 
in the quality of Rajas, the renaissance of his by-gone 
existences, and wakens up in his psychic plane the pic- 
tures of good or evil deeds done by him therein. 
Dreams are but the embodiment of these recollections. 
The self or Jivatmai, though he sleeps not himself, is 
said to be sleeping, whenever the sense organs are over- 
powered by the illusive energy of Tamas. 35. 

Day sleep is forbidden in all seasons of the year, 
except in summer and in the case of infants, old men, 
and persons enfeebled by sexual excesses, or in Kshata- 
kshina diseases and in case of habitual tipplers. A sleep 
in the day may be enjoyed after the fatigue of a long 
journey, riding, or physical labour, or on an empty 
stomach. It may be allowed as well to men suffering 
from the loss of fat, Kapham or blood, to those of 

* Such persons may get sleep only, when bting tired and exhausted 
they cease to think of their affairs. 

C f. Charaka :— When the active self of a person, tired in body and 
jnind, loses touch with his worldly affairs, sleep comes to him, 



Chap. IV.] SARIRA STHANAM. 151 

scanty perspiration, or of dry or parched constitution ; 
and also to those who have been suffering from indi^ 
gestion and who may sleep for a Muhurta (48 minutes) 
in the day time. Those who have kept late hours in 
the night may sleep in the day for half the time they 
have watched in the night (and no more). Day sleep is 
the outcome of perverted nature and all the Doshas of 
the body are aggravated by a sleep in the day, bringing 
on many a troublesome complaints such as cough, 
asthma, catarrh,heaviness of the body, aching or lassitude 
in the limbs, fever, loss of appetite etc. On the other 
hand, the keeping of late hours in the night develops 
symptoms (Upadrava) which are peculiar to the deranged 
Vayu and Pittam. ^6. 

lYIemorable Verses :~Hence, one should not 

sleep in the day, nor keep late hours. Having known both 
these acts to be injurious, the wise should observe 
moderation in sleep. A conformity to the preceding 
rule of conduct is rewarded with health, good humour, 
strength, healthful complexion, virility and beauty, a 
frame which is neither too fat nor too thin, and a long life 
of a hundred years). A day sleep may not prove injurious^ 
to those who are habituated to it and conversely keeping 
late hours at night may not tell upon the health of those 
to whom it is customary. 37-39. 

An aggravated condition of the bodily Vayu or 
Pittam, an aggrieved state of the mind, loss of vital 
fluid, and a hurt or an injury may bring on insomnia, the 
remedy being the adoption of measures antagonistic to 
those which destroy sleep. The following measures are 
useful in cases of sleeplessness -such as anointing the 
body, rubbing of oil on the head, soft massages of the 
body (with cleansing paste) and shampooing ; a diet 
consisting of cakes and pastry made up of Sali-rice and 



152 THE SUSHRUTA SAMHITA. Chap. IV.] 

wheat prepared with sugar or other derivatives of sugar- 
cane, sweet or soothing articles with milk or meat juice 
or flesh of animals of the Biskira or Viles'aya class, 
and eating of grapes, sugar and sugar-cane at night, are 
beneficial (^in such cases; ; so also a soft and pleasant 
bed, and easy and convenient seats and means of loco- 
motion. Hence, a wise physician should advise those 
and similar other measures to allay insomnia. 40-41. 

Excessive sleep should be remedied by emetics, 
Sansodhana measures, fastings, bleeding, and works 
which tend to disturb the mental equanimity of man. 
Keeping up at night is beneficial to persons afflicted with 
obesity, poison or the deranged Kapham ; so also a nap 
in the day is beneficial to people troubled with hiccough, 
colic pain, dysentery, indigestion, or thirst. 42-43. 

Somnolence or Drowsiness etc. : -in 

this kind of ligHt sleep, or in th^ preliminary stage of 
sleep, the sense organ? are overpowered and remain 
only partially cognisant of their respective objects and 
all (subjective and objective) symptoms of a sleepy 
person such as, yawning, sense off atigue and heaviness 
o( the limbs, present themselves in succession ; these are 
the special features of Tandrai. One (prolonged) inha- 
ling of the air through a widely open mouth and 
subsequent exhaling with the contraction of the limbs 
and tearful eyes are (all together) called Jrimbha^ or 
yawning. 

A sense of fatigue without any physical labour which 
comes upon a person unaccompanied by hurried res- 
piration is called Klama. It obstructs the proper 
functions of the senses as also the workings of the active 
organs.* An inordinate love of pleasure and a great 
aversion to pain, attended with an apathy to all sorts of 

* Hand, leg, anus, and generative organ etc. 



Chap. IV.] SARIRA STHANAM. 1 53 

work even with the capacity of carrying them through is 
called Alasyam (laziness). Nausea, without vomiting of 
invested food, attended with salivation and formation 
of sputum, and cardiac distress are the symptoms of 
Utklesham. A sweet taste in the mouth, drowsiness, 
a beating pain in the heart, dizziness, and non-relish 
for food are the signs of Glaiai (languor). A feeling as 
if the whole body were wrapped in a wet sheet, accom- 
panied by an extreme heaviness of the heart, is called 
Gauravam. 44- 50- 

Loss of consciousness (Murchchai) is due to an excess 
of the deranged Pittam and to the quality of the Tamas ; 
vertigo (Bhrama) is due to an aggravated state of the 
Vdyu, Pittam, and to the quality of the Rajas ; drowsiness 
(Tandra() is due to a similar condition of the Vdyu, 
Kapham and to the quality of the Tamas ; while sleep 
(Nidratj is produced by the predominance of Kapham and 
to the quality of the Tamas in the organism. 51. 

The growch of a foetus in the womb is effected by 
the serum (Rasa) prepared out of the food (assimilated 
by its mother) incarcerated by the Vdyu in the internal 
passage of its body. 52. 

Memorable Verses :— Be it dearly under- 
stood that there exists fire or heat (Jyoti) in the umbilical 
region of the foetus which is fanned by its bodily 
Vdyu and thus contributes to the growth of its body. 
The same Vayu in combination with the heat (thus 
generated), expands the upward, downward, and lateral 
channels (in the body of the embryo) and thus leads 
to the growth of the foetus. The eyes (Dristi— aper- 
ture of sight) and the hair-follicles of a man do not 

* lo the text we find the word "Indriya" which refers to both 
Jnanendriya (sensory functions) and Karmendriya (motor functions) of 
the body. 

20 



I$4 THE SUSHRUTA SAMHITA. [Chap. IV. 

participate at all (in the general expansion of the body). 
This is a law of nature, and is the opinion of Dhanvantari. 
.On the other hand the growth of hair and finger nails 
continue even when the body enters the stage of decay. 
This also is a law of nature. SS'S^* 

The Temperaments :— The temperaments 
(Prakriti) of persons may be of seven different types, 
according as the deranged Doshas of the body are 
involved therein, either severally, or in combination 
of two or of all the three together. The temperament 
(Prakriti) of a man is determined by the preponder- 
ance of the particular Doshas at the time of his genera- 
tion (actual combination of the semen and ovum) and 
is marked by that preponderant Dosha. The character- 
istics of the different Prakritis are now described. 57-58. 

Vataja-Temperament :— A man of Vdtika- 

temparament is wakeful, averse to bathing and cold 
contact, unshapely, thievish, vain, dishonest and fond 
of music ; the soles of his feet, and the palms of his 
hands are much fissured ; has often a rough and grisly 
beard and moustache, finger nails and hairs in him ; 
he is hot-tempered and is given to biting his finger 
nails and grinding his teeth (when asleep). Morally he 
is impulsive, unsteady in his friendship, ungrateful, lean, 
and rough ; his body is marked with a large number of 
prominent veins (Dhamani) ; he is incoherent in his 
habit and vacillating in his temper.- He is a fast walker 
and dreams of scaling the skies in his sleep. His eyes 
are always moving. His mind is never steady. He 
makes few friends, is capable of accumulating very 
little money and talks incoherently. The traits of 
his characteretc. seem to resemble those of a goat, 
jackal, hare, mouse, camel, dog, vulture, crow, and of an 

ass. 59-60. 



I 
I 



Chap. IV.] SARIRA STHANAM. 1 55 

Pittvaja-Tcmperamcnt :— A man of 

Pittvaja temperament perspires copiously emitting a fetid 
smell. His limbs are loosely shaped and yellowish in 
colour. The finger nails, eyes, palate, tongue, lips, soles 
and palms of such a person are copper-coloured. He looks 
ugly with wrinkles, baldness and grey hair; he eats much, 
is averse to warmth and irritable in temper, though he 
cools down very soon. He is a man of middling strength 
and lives up to middle age. He is intelligent and 
possesses a good retentive memory and loves to 
monopolise the conversation (by pulling down any 
speaker that may be present). He is vigorous and 
is simply irresistible in battle. He dreams in his 
sleep of such things as meteors, lightning-flashes, fire, 
Ndgeshvara, Palas'a or Karnikara plants. He is never 
overpowered with fear nor bends before a powerful 
antagonist ; he protects the suppliant and is very often 
afflicted with suppuration in the cavity of the mouth. 
The traits of his character resemble those of a serpent, 
an owl, a Gandharba (heavenly musician), Yaksha, cat, 
monkey^ tiger, bear, and of a mongoose. 61-64. 

Kaphaja-Tempcrament : —The complexion 

of a man of 5 leshmd temperament resembles either 
the colour of a blade of grass, blue lotus, polished 
sword, wet Arishta, or that of the stem of the Sara grass. 
He is comely in appearance, fond of sweet tastes, 
grateful, self-controlled, forbearing, unselfish and strong ; 
he does not hastily form any opinion, and is fast in his 
enmity. His eyes are white ; his hair curly and raven 
black. He is prosperous in life. His voice resembles the 
rumblings of a rain-cloud, the roar of a lion, or the 
sound of a Mridanga. He dreams in his sleep of large 
lakes or pools decked with myriads of full blown lotus 
flowers, swans and Chakravdkas. His eyes are slightly 



156 THE SOSHRUTA SAMHITA. [Chap IV. 

red towards the corners, the limbs are proportionate and 
symmetrically developed with a cool effulgence radiating 
from them He is possessed of the qualities of the 
Sittvika stamp, capable of sustaining pain and fatigue 
and respectful towards his superiors He possesses faith 
in the Sdstras and is unflinching and unchanging in his 
friendship ; he suffers no vicissitudes of fortune, makes 
large gifts after long deliberation, is true to his word 
and always obedient to his preceptors. The traits of his 
character resemble those of Brahma, Rudra, Indra, 
Varuna, a lion, horse, an elephant, cow, bull, an eagle, 
swan and of the lower animals. 65-68. 

A combination of two different temperaments should 
be called a double temperament or a Dvandaja one ; 
and one of all the three temperaments in a person 
should be stated as a Satnnipaitika one. 69. 

The temperament of a man is never altered, nor 
does it suffer any deterioration or abatement. A 
change, abatement or deterioration in any particular 
case should be regarded as the harbinger of death. 
As a worm, bred in poison, is not troubled with it, 
so the temperament of a person however painful to 
others does no inconvenience to himself. Several 
authorities hold that the temperaments of persons have 
their origin in the material elements of the body and 
accordingly they classify them as the Va'tika Prakriti, 
the Taijasa Prakriti, and the Apya (watery) Prakriti, 
the characteristic traits of which respectively correspond 
to the first three temperaments described above. 70—71. 

A man of the Pairthiva temperament is large in 
his stature, and is firm, strong and muscular in his limbs. 
A man of the Nabhasa temperament is pious and 
long-lived, has large aural cavities. The mental tempera- 
ments are classified according to their qualities. 72. 



Chap. IV.] SARIRA STHANAM. 1 57 

Sattvika Features :— The features of a 

Brahma-kaiya person are cleanliness of person and con- 
duct, belief in the existence of God, a constant reader of 
the Vedas, a worship and reverence of elders and 
preceptors, hospitality and celebration of religious 
sacrifices. Those of a Mahendra-ka^ya person are valour, 
command, constant discussion of the Sastras, main- 
tenance of servants and dependents and magnanimity. 
The features of a Karnna-ka^ya person are a liking for 
exposure to cold, forbearance, a brown hue of the pupils, 
golden colour of the hair and sweet speech. The 
features of a Kouvera-kaya person are, arbitration 
of disputes, capacity of bearing hardships, earning and 
accumulation of wealth, and capacity of propagation 
or fertility. The features of a Gandharva-kaya person 
are love of garlands and perfumes, fondness of songs 
and music, and love making. The features of a Yamya- 
Sattva person are sense of duty, promptness, firmness 
of action, courage, memory, purity, and absence 
of anger, illusion, fear and malice. The features of a 
Rishi-Sattva man are divine contemplation, obser- 
vance of vows, complete sexual abstinence, performance 
of Homas, celebration of religious sacrifices, knowledge, 
wisdom and cultivation of divine or spiritual science. 
These seven types of men should be considered as 
belonging to the Sattvika group (of Sdttvika mental 
temperament). Now hear me describe the features of 
men of Rdjasika stamp (of mind). 73. 

R^ijasika Features :— Asura-Sattva men 

are affluent in circumstances, dreadful, valorous, irascible, 
jealous of other men's excellence, gluttonous and fond 
of eating alone without sharing with any one else. A 
Sarpa-Sattva man is irritable, laborious, cowardly, 
angry, double-dealing, and hasty in eating and sexual 



i$S THE SUSHRUTA SAMHITA. [Chap. IV. 

intercourse. A ^akuna-Sattva man is gluttonous, 
intemperate in sexual matters, irritable and fickle. A 
Ratkshasa-Sattva man is solitary in his habits, fierce, 
jealous of others excellence, externally pious, extremely 
vain and ignorant. The characteristics of a Paisaclia- 
Sattva man are eating food partaken of by another, irri- 
tability of temper, rashness, shamelessness, and covetous- 
ness of female possessions. Those of Preta-Sattva man 
are utter want of knowledge as regards duty, laziness, 
miserableness, envy, covetousness, niggardliness. These 
six belong to the Rajasika cast of mind. Now hear 
me describe the characteristic traits of men of the 
Tamasika temperaments. 74. 

Tamasika Features:— The features of a 

Pais'ava-Sattva man are perverseness of intellect, parsi- 
moniousness, frequent sexual dreams and incapacity of 
ascertaining or discerning anything. The features of 
Matsya-Sattva man are unsteadiness, stupidity, cowar- 
dice, fond of intermissive quarrel and oppression and a 
longing for water. The features of a Vanaspati-Sattva 
man are fondness of staying at the same place, constant 
eating and absence of truthfulness, piety, riches and 
enjoyment. Thus the three types of Tamasika tempera- 
ment have been described, A physician should take in 
hand a patient with an eye towards these mental traits 
etc. A physician should coolly deliberate upon the 
different types of temperament described herein and 
their characteristic features. 7S'7^- 

Thus ends the fourth Chapter of the S'arira Sthdnam in the S'uss'ruta 
Samhita which treats of foetal development etc. 



CHAPTER V. 

Now we shall discourse on the Sariram which treats 
of the anatomy of the human body (SsTrira- 

^ankhya-Vyakaranam). i. 

Definition of Garbha and ^arira ;— 

The combined semen and ovum (Sukra and Sonita) in 
the womb, mixed with (the eight categories known as) 
the Prakriti and (her sixteen modifications known as) 
Vikdra, and ridden in by the Atmat (self-consicous self^, 
is called the foetus. There is consciousness in the 
embryo. The Vatyu (or the vital force) divides it into 
Dosha, Dhdtu, Mala, etc., limbs, and organs, etc. The 
Teja (or the heat latent in the fecundated matter) gives 
rise to the metabolism of the tissues ; the Apa (water) 
keeps it in a liquid state ; the Kshiti (earth) is embodied 
in the shape of its species ; and the Akas'a (ether) contri- 
butes to its growth and development. A fully developed 
foetus with all its parts, such as the hands, feet, tongue, 
nose, ears, buttocks etc. and the sense-organs, is called 
Satriram or body. The body is composed of six 
main parts, namely, the four extremities (upper and 
lower), the trunk or middle body, and the head. 2. 

Different members of the body :— Now 

we shall describe the Pratyangas or members of the 
body. The head, the belly (Epigastrium), the back, the 
navel (umbilical region), the forehead, the nose, the chin, 
the bladder, and the throat (neck), occur singly ; the 
ears, the eyes, the nostrils, the eye-brows, the temples, 
the shoulders, the cheek, the armpits, the breasts, the 
testes, the sides, the buttocks, the arms, the thighs, and 
the knee-joints, etc., occur in pairs. The fingers and 



l6o THE SUSHRUTA SAMHITA . [Chap, V. 

toes which number twenty in all, and the interior 
channels (Srotas) of the body, to be presently described, 
are likewise included within the Pratyangas. These 
are the different Pratyang'as or members. 3. 

Enumeration Of the different limbs 
and members of the body :— The different 

layers of the skin, the Kalas, the Dhatus (root principles, 
such as blood, chyle, etc.), the Mala (excrements , the 
Doshas (morbific principles, such as the Vayu, Pittam, 
or Kapham\ the spleen, the liver, the lungs, the colon 
and caecum (Unduka), the heart, the cavities or viscera 
(Asayas), the intestines (Antras), the Vrikkou (Kidneys) 
the Srotas (internal passages or ducts), the Kandara 
(nerve trunks), the Jalas (membranes), the Kurchas,* the 
Rajjus (tendons) the Sevanis (sutures), the Sanghdtas 
(facets), the Simanta, the bones, the joints, the Snd,yu 
(ligament), the Pes'i (muscles), the Marmas (vital parts, 
such as anastomosis of veins and arteries, etc.), the Sira 
(veins), the Dhamani (arteries), and the Yogavahini 
Sr5tasf, constitute what is collectively called the 
organism. 4. 

Their number :— The layers fof skin (Tvaka) 
number seven in all. There are seven connective tissues 
or fascia (Kalds). The cavities or viscera (Asayas) are 
seven in all. The root principles (Dhatu) of the body 
are seven in number. There are seven hundred S'ird 
(veins), five hundred Pes'i (muscles), nine hundred 
Snayu (ligaments), three hundred bones, two hundred 
and ten Sandhi ^joints), one hundred and seven Marmas 
(vital parts), twenty-four Dhamanis (arteries etc.), three 
Doshas (morbific principle— such as the V^yu, Pittam, 

* Meetings of muscles, ligament?, veins, nerves and bones as at the 
annular ligament. 

t Those, that are in connection with the Dhamani. 



Chap, v.] SARIRA STHANAM, i6g^ 

to the Sushira type. The ligaments of the chest, back, 
sides and head are of the Prithu type. 34—35. 

As a boat made of planks and timber fastened 
together by means of a large number of bindings 
is enabled to float on the water and to carry cargo ;• 
so the human frame being bound and fastened at the 
Sandhis or joints by a large number of ligaments. 
(Snayu) is enabled to bear pr:^ssure. An injury to,, or 
diseases of, the bones, veins, joints or muscles are not so 
detrimental to the system as is the case if the Snayus 
are affected in any way. Only the physician, who is 
acquainted with the internal and external ligaments 
(Sndyus) of the body, is qualified to extract a hidden 
and imbedded Salyam (extraneous matter etc.) from any 
part of the body. 36. 

The lYIuSCleS (PcsiS) :— The muscles (Pesis) 
number five hundred in all, of which four hundred 
are in the four extremities ; Sixty-six* in. the 
trunk (Koshtha) and thirty-four in the region above the 
clavicles. 37. 

IVIuscIes in the Extremities :— There are 

three muscles in each of the toes, thus making .fifteen 
in the toes of one leg ; ten in the anterior part of the foot 
and the same number (ten") attached to the Kurchcha ; 
ten in the sole and the ankle-bone (Gulpha, — malledi) ; 
twenty in the region between the Gulpha and the knee- 
joint ; five in the knee-joint (Janu) ; twenty in the thigh 
(Uru) ; and ten in the groin (Vankshana) ; thus making 
one hundred muscles in all in each leg. The same 
number is found in each of the other three extremities ; 
(thus making four hundred in all). 2^. 

Muscles in the Koshtha : -(Of the sixty- 
six muscles in the trunk), three are in the region of the 

* Gayadasa reads sixty in the trunks and forty above the clavicles, 

22 



170 THE SUSHRUTA SAMHITA. Chap. V.] 

anus (Pa/u) ; one In the penis; one in the perineum 
(Sevan i) ; two in the scrotum ; five in each of the 
haunches (Sphik) ; two in the top or head of the 
bladder ; five in the abdomen (Udara) ; one about the 
umbilicus ; five along each side (of the spinal column), 
on the upper part of the back (making ten in all) ; six 
in the sides ; ten in the chest ; seven around the armpits 
and shoulders (Akshaka-Ansa) ; two in the region of 
heart and stomach (Amas'aya) ; and six in the region 
of the liver, spleen and colon (Unduka). 39. 

IVIuscIesof the Head and Neck :— (Of 

the thirty-four muscles found in this region), four are in 
the throat (Grivd) ; eight in the two jaw-bones (Hanu) ; 
one each in the regions of the throat (Kakalaka and 
Gala) ; two in the palate ; one in the tongue ; two in 
the lips : two in the nose ; two in the eyes ; four in the 
cheeks ; two in the ears ; four in the forehead ; and 
one in the head. Thus the positions and distribu- 
tions of the five hundred muscles (Pesis) have been 
described. 40. 

Metrical Text :~The ligaments, veins, bones 
and joints etc., of a human body, derive their strength 
from the fact of their being supported by or covered over 
by the muscles. 41. 

Extra IVIuscIes in Women :— Females 

have twenty extra muscles ; ten muscles are to be found 
about the two breasts, five in each, which (muscles) 
attain their full growth during puberty ; four muscles 
are present about the parturient passage ; and of these 
(four) two are about the external and two in the internal 
orifices (of the vagina) ; three about the region of the 
OS, and three along the passages of the ovum and sperm. 
The Garbhasaya or uterus is situated in the space 
bounded by the Pittas'aya (small intestine) and Pakv^s'aya 



Cliap. V.j SARIRA STHANAM. I^I 

(large intestine) and the foetus lies in this during the 
period of gestation.* 42-43. 

According to their position in the system, these 
muscles are found to be thick, slender, small, expanded, 
circular, short, long, hard, soft, smooth or rough. The 
muscles cover the veins, ligaments, bones and joints; 
hence their shape and size are determined by the 
exigencies (organic structures) of their positions. 44. 

Memorable Verses : -The muscles which 

are found in the penis and scrotum of a man as des- 
cribed before correspond to the covering of the uterus 
in the case of a woman owing to the absence of those 
organs in her body. The positions and classifications 
of the veins, channels, Marmas and arteries will be 
dealt with in a separate chapter. 45-46. 

The vagina of a woman resembles the navel of a 
conch-shell in shape and is possessed of three involuted 
turns (Avartas) like the interior of mollusc. The uterus 
(Garbhas'aya — foetal bed) is situated at the third posterior 
involuted turn. The shape of the uterus resembles the 
mouth of a Rohit-fish (narrow at the mouth and expanded 
in the upper end). The foetus lies in a crouched or 
doubled up posture in the uterus and thus naturally at 
the time of parturition its head is presented at the 
entrance to the vagina. 47-48. 

Superiority of ^alya-Tantram :-The 

different parts or members of the body as mentioned 
before including even the skin cannot be correctly 
described by any one who is not versed in Anatomy. 
Hence, any one desirous of acquiring a thorough 
knowledge of anatomy should prepare a dead body 
and carefully observe (by dissecting it) and examine 

* If we read Mutras.'aya (bladder) in place of Piltda'aya it explains 
the anatomy better.— Ed, 



-iJ2 THE StJSHRUTA SAMHITA. Chap. V.] 

its different parts. For a thorough knowledge can only 
be acquired by comparing the accounts given in the 
SAstras' (books on the subject) by direct personal 
observation. 49. 

IVlode of dissection :— A dead body selected 
for this purpose should not be wanting in any of its parts, 
should not be a person who had lived up to a hundred 
years (i. e. too old age) or ol one who died from any 
protracted disease or of poison. The excrementa should 
be first removed from the entrails and the body should 
be left to decompose in the water of a solitary and still 
pool, and securely placed in a cage (so that it may not be 
eaten away by fish nor drift away), after having covered 
it entirely with the outer sheaths of Munja grass, Ktis'a 
grass, hemp or with rope etc. After seven days the body 
would be thoroughly decomposed, when the observer 
should slowly scrape off' the decomposed skin etc. with a 
whisk made of grass-roots, hair, Kusa blade or with a 
strip of split bamboo and carefully observe with his own 
eyes all the various different organs, external and internal, 
beginning with the skin as described before, 50 — 56. 

IVlemorabIc Verses :— The Self, the occult 

or invisible Lord of the body cannot be detected except 
with the psychic eye or with that of the mind. He, who 
has observed the internal mechanism of the human body 
and is well read in the works bearing on these subjects 
and has thus all his doubts expelled from his mind is 
alone qualified in the science of Ayurveda and has a 
rightful claim to practise the art of healing. 57. 

Thus ends the fifth Chapter of the S'arira-sthanam in the Sus'rula 
Samhitii w hich treats of the anatomy of the human body. 



CHAPTER VI. 

Now vvc shall discourse on the Sdrlram which speci- 
fically treats of the Mannas* or vital parts of the body 

(Pratyeka-marma-nirdcsa Sariram.) i. 
Classification of IVI arm as :— There are 

one hundred and seven Marmas (^in the human organ- 
ism), which may be divided into five classes, such as 
the Mcinsa-Marmas, Sira-Marmas, Sndyu-Marmas, Asthi- 
Marmas and the Sandhi-Marmas. Indeed there are no 
other Marmas (vulnerable or vital parts) to be fuund 
in the body than the preceding ones. 2. 

Their different numbers :— There are 

eleven Mansa-Marmas (vulnerable muscle-joints) ; forty- 
one Sird-Marmas (similar veins, anastomosis) ; twenty- 
seven Snayu-Marmas (vital ligament-unions) ; eight 
Asthi-Marmas (bone-unions) and twenty Sandhi-Marmas 
(^vulnerable joints). 3. 

Their Locations :~0f these, eleven are in 
one leg, thus making twenty-two in the two lower ex- 
tremities, The same number counts in the two hands. 
There are twelve Marmas in the regions of the 
chest and the abdomen (Udara) ; fourteen in the back ; 
and thirty-seven in the region of the neck (Griva) and 
above it. 4. 

Names and distributions of IVIarmas : 

— The Marmas which are situated in each leg are known 
as Kshipra, Tala-Hridaya, Kurchcha, Kurchcha-Sirah, 
Gulpha, Indravasti, Janu, Ani, Urvi, Lohitaksha and 
Vitapa. The twelve Marmas which are situated in the 

Places where veins, arteries, ligaments, joints and mu.cles unite 
and an injury to which proves j^encrally fatal. 



i 



i;?'4 THE SUSHRUTA SAMHItA. Chap. Vl.] 

thorax and the abdomen (Udara) are Guda (anus), Vast! 
(bladdery, xN^abhi (umbilicus), Hridaya (heart), Stana- 
mula (the roots of two breasts), the Stana-Rohita, 
(muscles of the breasts\ the two Apalaps and the two 
Apastambhas. The fourteen Marmas to be found in 
the back are the Katika-tarunas (Taruna-bones of the 
waist', the two Kukundaras, the two Nitamvas (hips), 
Pars va-Sandhis (the two side-joints), the two Vrihatis, 
the two Ansa-phalnkas (shoulder-blades) and the two 
Ansas (shoulders). The eleven Marmas to be found in an 
arm are known as the Kshipra, Tala-Hridaya, Kurchcha, 
Kurchcha-Sirah, Manivandha, Indravasti, Kurpara, 
Ani, Urvi, Lohitaksha and Kakshadhara. What is said of 
the one arm holds good of the other. The Marmas situated 
above the clavicle regions are known as the four Dhamanis, 
the eight Matrikas,the twoKrikatikas, the two Vidhuras, 
the two Phanas, the two Apangas, the two Avartas, the 
two Utkshepas, the two Sankhas, one Sthapani five 
Simantas, four Sringatakas and one Adhipati. 5—9. 

The different heads of IVIarmas:— Of 

the aforesaid Marmas, those known as the Tala- 
Hridaya, Indravasti, Guda and Stana-rohita, are 
Mayas a- Marmas. Those known as Nila-dhamani, 
Matrika, Sringataka, Apanga, Sthapani, Phana, Stana- 
mula, Apalapa, Apastambha, Hridaya, Nabhi, Pars'va- 
Sandhi, Vrihati, Lohitaksha and Urvi, are Sirat-Marmas. 
Those known as the Ani, Vitapa, Kakshadhara, 
Kurchcha, Kurchcha-Sirah, Vasti, Kshipra, Ansas, 
(shoulders), Vidhura and Utkshepa, are Snaiyu-Marmas. 
Those known as the Katika-taruna, Nitamva, Ansa- 
phalaka, Sankha, are Asthi-Marmas. The Janu, the 
Kurpara, the Simanta, the Adhipati, the Gulpha, the 
Manivandha, the Kukundara, the Avarta and the 
Krikatika arc Saudhi-Marmas. 10—14. 



Chap. VI.] SARIRA ST HAN AM. 1/5 

Qualitative classes :— Again these Marmas 
(vital unions of the body) are under five distinct heads, 
namely, Sadya-Pranahara, (fatal within twenty-four 
hours), Kalantara-Pranahara, (fatal within a fortnight 
or a month), Visalyaghna (fatal as soon as a dart or any 
other imbedded foreign matter is extracted therefrom), 
Vaikalyakara, (maiming or deforming) and Rujakar 
(painful) [according as an injury respectively produces 
the aforesaid effects]. Of these, nineteen Marmas 
belong to the Sadya-Prdnahara group ; thirty-three to 
the Kalantara-Pranahara group ; three to the Visalya- 
ghna group; forty-four to the Vaikalyakara group ; and 
eight to the Rujcikara group. 15. 

Memorable Verses :— To the Sadya-Praina- 

hara group (fatal in the course of a day if anywa\' hurt) 
belong the four Sring^takas, one Adhipati, the two 
Sankhas, the eight Kantha-Sirds, the Guda, the 
Hridaya, the Vasti and the Nabhi. To the Kailadltara- 
Pranahara group (fatal later on, if any way hurt) 
belong the eight Vaksha-Marmas, the five Simantas, 
the four Tala-Marmas, the four Kshipra-Marmas, the 
four Indra-vastis, the two Katika-tarunas, the two 
Parsva-Sandhis, the two Vrihatis, and the two 
Nitamvas. To the Visalyaghna class belong the two 
Utkshepas and the one Sthapani. To the Vaikalyakara 
(deforming) group belong the Marmas, known as the 
four Lohitakshas, the four An is, the two Jdnus, the 
four Urvis, the four Kurchchas, the two Vitapas, the 
two Kurparas, the two Kukundaras, the two Kaksha- 
dharas, the two Vidhuras, the two Krikatikas, the two 
Ansas (shoulder), the two Ansa-phalaka.s, (shoulder- 
blades), the two Apangas (tips of eyes), the two Nials, 
the two Manyas, the two Phanas and the two Avartas. 
A learned physician should know that the two Gulphas, 



176 THE SUSHRUTA SAMIIITA. [Chap. VI. 

the two Mani-vandhas and the four Kurchcha-S'irah (of 
the hands and legs) belong to the Rujakara group 
(painful if hurt). A piercing of the Kshipra-Marma 
ends in an instantaneous death ; or death may follow 
at a later time. 16-2 t. 

Firm unions of Mdnsa (muscles), Sira (veins), Snayu 
(ligaments), bones or bone-joints are called Marmas 
(or vital parts of the body) which naturally and specifi- 
cally form the seats of life (Pratna), and hence a hurt to 
any one of the Marmas invariably produces such symp- 
toms as arise from the hurt of a certain Marma.* 22. 

The Marmas belonging to the Sadya-Pranahara group 
are possessed of fiery virtues (thermogenetic) ; as 
fiery virtues are easily enfeebled, so they prove fatal 
to life (in the event of being any way hurt) ; while 
those belonging to the Kalantara-Pranahara group are 
fiery and lunar (cool) in their properties. And 
as the fiery virtues are enfeebled easily and the cooling 
virtues take a considerable time in being so, the 
Marmas of this group prove fatal in the long run (in 
the event of being any way hurt, if not instantaneously 
like the preceding ones). The Vis'alyaghna Marmas 
are possessed of Vataja properties (that is, they arrest 
the escape of the vital Vayu) ; so long as the dart 
does not allow the Vayu to escape from their injured 
interior, the life prolongs ; but as soon as the dart is 
extricated, the Vayu escapes from the inside of the 
hurt and necessarily proves fatal. The Vaikalyakaras 
are possessed of Saumya (lunar properties) and they 
retain the vital fluid owing to their steady and cooling 
virtues, and hence tend only to deform the organism 

* Some are of opinion that hallucination, delirium, death, stupor and 
coma as described in the Sutrast anam are the results of injuries to 
thes Mar as. 



Chap. VI.] SARIRA STHANAM. IJJ 

in the event of their being hurt, instead of bringing 
on death. The Ruj^kara Marmas of fiery and Vataja 
properties become extremely painful inasmuch as both 
of them are pain-generating in their properties. 
Others, on the contrary, hold the pain to be the result 
of the properties of the five material components of 
the body (Pancha-bhautika). 23. 

Different Opinions on the IVIarmas : — 

Some assert that Marmas, which are the firm union of 
the five bodily factors (of veins, ligaments, muscles, bones 
and joints), belong to the first group (Sadya-Prana- 
hara) ; that those, which form the junction of four such, or 
in which there is one in smaller quantity, will prove fatal 
in the long run, in the event of their being hurt or injured 
(Kdldntara-Pranahara).* Those, which are the junction 
of three such factors, belong to the Vis'alya-Prcinahara-f* 
group ; those of the two belong to the Vaikalyakara X 

* The Marmas, such as Stana-mula, Apalapa, Apastambha, 
Simanta, Katika-Taruna, Parsva-Sandhi, Vrihati, and Nitamva be- 
longing to the Kalantara-maraka group, are devoid of Mansa (muscles) ; 
and the 'Marmas' known as Stanarohita, Talahridaya, Kshipra, and 
Indravasti, belonging to the same class, are devoid of Asthi (honest 

t The Ulkshepa marma, belonging to the Vis'alya.pr^nahara 
group, is devoid of Mansa (muscles) and Sandhi (joint). 

X The Sthapani- Marma, belonging to the Vaikalyakara class, is 
devoid of Mansa (muscle), S'ira and Snayu ; (he Lohitaksha-marma 
(of the same group) is devoid of Snayu, Sandhi and Asthi (bones) ; the 
Janu-marma (of the same group) is devoid of Mansa, S'ira and Snayu: 
the Urvi-marma (of the said group) is devoid of Asthi, Mansa and Snayu ; 
the Vitapa-marma (of the same class) is devoid of Mansa, Sira and Asthi ; 
the Kurpara-marma (of the same class) is devoid of Mansa, S'ira, 
and Snayu ; the Kukundara-marma (of the same class) is devoid 
of Mansa, S'ira and Sandhi ; the Kakshadhara-marma (of the same 
class) is devoid of S'ira, Asthi, and Sandhi ; the Vidhura-marma (of the 
said group) is devoid of Mansa, Sira and Sandhi ; the Krikatika-marma 
is devoid of Mansa, S'ira, and Sandhi; the Ansa-marma (of the same 
group) is devoid of Mansa, Snayu and Sandhi ; the Ansa-phalaka-marma 

2\ 



178 THE SUSHRUTA SAMHITA . [Chap. VI. 

group ; and those in which only one of them exists 
belongs to the last or pain-generating type (Rujdkara)*. 

But the fore going theory is not a sound one, inas- 
much as blood is found to exude from an injured joint 
which would be an impossibility in the absence of any 
vein, ligament (Snayu) and muscle being intimately 
connected with it. Hence every Marma should be 
understood as a junction or meeting place of the five 
organic principles of ligaments, veins, muscles, bones 
and joints. 24-25. 

IVletrical text:— This is further corroborated 
by the fact that the four classes of Sira or vessels (which 
respectively carry the Vdyu, Pitta, Kapha and the blood) 
are found to enter into the Marmas for the purpose 
of keeping or maintaining the moisture of the local 
ligaments (Snayu), bones, muscles and joints and thus 
sustain the organism.f The Vayu, aggravated by an 
injury to a Marma, blocks up (those four classes of 
vessels) in their entire course throughout the organism 
and gives rise to great pain which extends all over the 
body. All the internal mechanism of a man (of which a 
Marma has been pierced into with a shaft or with any 
other piercing matter) becomes extremely painful, and 
seems as if it were being constantly shaken or jerked, 
and symptoms of syncope are found to set in. Hence a 
careful examination of the affected Marma should 

(of the said group) is devoid of Mansa, Snayu and Sandhi ; the Nila, 
Manya and Phana Marmas (of the same group) are devoid of Mansa, 
Sandhi and Asthi ; the Avarta-marma is devoid of S'irsL, Sniyu and 
Mansa ; the Apdnga. marma (of the said class) is devoid of Mansa, Sniyu 
and Sandhi. 

* The Gulpha, Manibandha, and Kurchcha-s'ira Marmas, belonging 
to the Rujakara group, are devoid of Mansa, S'ir^, Sniyu and Asthi, i.e. 
Sandhi alone is present in these. 

t Hence the piercing of a bone is attended with bleeding. 



Chap. VI.] SARIRA STHANAM, 179 

precede all the foregoing acts of extricating a Salya from 
its inside. From that similar aggravated conditions and 
actions of the Pitta and the Kapha should be presumed 
in the event of a Marma being any v^ay injured or 
pierced into. 26—29. 

A Marma of the Sadyah-Pr^nahara type being 
perforated at its edge brings on death at a later time 
(within seven days), whereas a deformity of the organ 
follows from the piercing of a Kdlantara-Miraka* 
Marma at the side (instead of in the centre). Similarly, 
an excruciating pain and distressful after-effects mark a 
similar perforation of a Marma of the Vis'alyaghnaf 
group. And a Marma of the Rujdkara|: class pro- 
duces an excruciating pain (instead of a sharp one) in 
the event of its being pierced at the fringe. 30. 

An injured Marma of the Sadyah-Pranahara type 
terminates in death within seven days of the injury, 
while one of the Kaldntara type, within a fortnight or a 
month from the date of hurt (according to circumstances). 
A case of injured Kshipra-Marma seldom proves fatal 
before that time (seven days). An injured Marma of the 
Vis'alyaghna or Vaikalyakara group may prove fatal 
in the event of its being severely injured. 31. 

Marmas of the Extremities :— Now we 

shall describe the situation of every Marma. The 

* If any of the Marmas of the Kalanlara-Pranahara group be 
deeply perforated, then this perforation is sure to bring on death within 
a day {i.e. it will act like a slightly injured Marma of the Sadyah- 
Pranahara group). 

t Any M.-irma of the Vis'aiyaghna-group, being deeply perforated, 
brings on death within seven days (/. e. it will behave like a slightly 
injured Marma of the Kalantara-Prknahara class). 

t Any Marma of the. Rujakara class, being deeply perforated (injured), 
is sure to bring excruciating pain etc, (i.e., it will act like a slightly 
injured Marma of the Vis'alyaghna group). 



rSo THE SUSHRUTA SAMHITA. [Chap. VI. 

Marma, known as the Kshipra*, is situated in the 
region between the first and the second toes (Tarsal 
articulation), which, being injured or pierced, brings 
on death from convulsions. The Marma, known as the 
Tala-Hridayat, is situated in the middle of the sole 
of the foot in a straight line drawn from the root of 
the middle toe. An injury to this Marma gives rise to 
extreme pain which ends in death. The Marma, known 
as the Kurchchat, is situated two fingers' width 
above from the Kshipra one on each side of the 
foot. An injury to this Marma results in shivering 
and bending in of the foot. The Marma called 
Kurchcha-Sirah § is situated under the ankle-joints, 
one on each side of the foot (Gulpha-Sandhi) ; an 
injury to it gives rise to pain and swelling of the 
affected part. A perforation of the Gulpha-Marma !!, 
which is situated at the junction of the foot and 
the calf, results in pain, paralysis and maimedness 
of the affected leg. 32-37- 

An injury to the Marma which is. situated in the 
middle muscle of the calf to the distance of between 
twelve and thirteen fingers' width from the ankle, and 
known as the Indravasti-Marma^lT results in excessive 
haemorrhage which ends in death. 38. 

* It is a Snayu-Marma (ligament) to the width of half a finger, and 
belongs to the Kalantara group. 

t It is a Mansa-Marma to the width of half a finger and belongs to the 
Kalantara group. 

:; It is a Snayu-Marma to the length of four fingers' width, and 
belongs to the Vaikalyakara group. 

§ It is a Snayu-Marma, one finger in length and belongs to the 
Vaikalyakara group. 

II It is a Sandhi-Marma, to the length of two fingers', and belongs to 
the Vaikalyakara group. 

IF Indravasti measures two fingers in length according to Bhoja and 



Chap. VI.] SARIRA ST HAN AM. iSl 

An injury to or piercing of the Jatnu-Marma* 
situated at the union of the thigh and the knee, results 
in lameness of the patient. 39. 

A piercing of the Aui-Marma,+ situated on both the 
sides above three fingers' width from the Jdnu (knee joint), 
brings on swelling and paralysis (numbness) of the 
leg. 40. 

A perforation of the Urvi-Marma,t situated in the 
middle of the Uru (thigh), results in the atrophy 
of the leg, owing to the incidental haemorrhage. An 
injury to the Lohitaiksha-Marma,ll situated respectively 
a little above and below the Urvi-Marma and the 
Vankshana (groin-joint), and placed near the thigh, is 
attended with excessive haemorrhage and causes para- 
lysis (of the leg). 41-42. 

An injury to the Vitapa-Marma,^ situated between 
the Scrotum and the Vankshana (inguinal region), brings 
on loss of manhood or scantiness of semen. Thus the 
eleven Sakthi-Marmas of one leg have been described ; 
those in the other being of an identical nature with the 
preceding ones. The Marmas in the hands are almost 
identical with those of the legs, with the exception that 
Manivandha, Kurpara and Kakshadhara Marmas 

Gayadasa, though half a finger in width according to others. It is a 
Mansa-Marma and belongs to the Kalantara group. 

* It is a joint-Marma, three fingers in length and belongs to the 
Vaikalyakara group. 

t It is a ligam';nt-Marma, half a finger in length, (three fingers 
according to Gayadasa) and is of the Vaikalyakara class. 

X It is a S'ira-Marma, half a finger in length and of the Vaikalya- 
kara group, 

II It is a S'ira-Marma, halfa finger in length and of the Vaikalya. 
kara group. 

IT It is a Snayu-Marma to the length of one finger and of the 
Vaikalyakara group. 



l82 THE SUSHRUTA SAMHITA. [Chap. VI. 

occur in the place of the Gulpha, Jdnu and 
Vitapa Marmas respectively. As the Vitapa-Marma 
is situated between the scrotum and the Vankshana 
(inguinal region), so the Kakshadhara-Marma is situated 
between the Vaksha (chest) and the Kaksha (armpit). 
An injury to these causes supervening symptoms. 
An injury to the Manivandha-Marma (wrist-marma) 
results specially in inoperativeness (Kuntha) of the 
affected hand ; an injury to the Kurpara-Marma ends 
in dangling (Kuni) of the hand ; and an injury to 
the Kakshadhara results in hemiplegia. Thus the 
forty-four Marmas of the upper and the lower extremi- 
ties have been described. 43-46. 

Marmas on the Thorax etc. :— Now we 

shall describe the Marmas, situated in the region of 
the thorax and the abdomen (trunk). A hurt to 
the Guda-Marma*, which is attached to the large 
intestine and serves as the passage of stool and flatus, 
ends fatally (within twenty-four hours of the hurt). 
An injury to the Vasti-Marma,t situated inside 
the cavity of the pelvic region and the bladder and 
composed of small muscles and blood (and which 
serves as the receptacle of urine), proves fatal with- 
in the day, except in the cases of extracting the 
gravel, only when the injury to the organ is short 
of complete perforation of both of its walls. The 
urine oozes out through the aperture in the case 
where only one of its walls has been perforated, and 
which may be closed and healed up with proper 
and judicious medical treatment. An injury to the 

* It is a Mansa-Marma to the length of four fingers' width and be. 
long? to the Sadyo-maraka class. 

+ It is a ligament combination (Snayumarma) to the length of four 
fingers, belonging to the Sadyah-Pranhara class. 



Chap. VI.i SARIRA STHANAM. 183 

Natbhi-Marma,* the root of all the Siras and situated 
between the Amdsaya (stomach) and the Pakv^s'aya 
(intestines) ends in death within the day. 47-50. 

A hurt to the Hridaya-Marma,t which is situated 
in the thorax between the two breasts and above the 
pit of the Amasaya and forms the seat of the qualities 
of Sattva, Rajas and Tamas, proves fatal within the 
day. An injury to the Stana-mula-Marmas,]: situated 
immediately below each of the breasts and about two 
fingers in width fills the Koshtha (thorax) with deranged 
Kapha, brings on cough, difficult breathing (asthma) 
and proves fatal. An injury to any of the Stana- 
Rohita-Marinas,§ situated above the nipples of 
the breasts about two fingers in width, fills the cavity 
of the Koshtha (thorax) with blood, producing symptoms 
of cough and asthma, and ends fatally. An injury to 
the Apalaipa-Marmas,!! situated below the Ansa-kuta 
(balls of the shoulders) and above the sides (meeting 
of the different branches of the sub-clavicle veins ue. 
axilla', transforms the blood of the organism into pus 
and proves fatal thereby. 51-54. 

An injury to any of the Vayu-carrying vessels, known 
as the Apastambha-Marmalf (meeting of the bifurcated 
branches of the bronchi lying on both the sides 

* It is a S'ira-Marma to the length of four fingers, belonging to the 
Sadyah-Pranahara class. 

t It is a S'ira-Marma to the length of four fingers and of the Sadyah- 
Pranahara class. 

+ It is a S'ira-Marma, two fingers in length and of the Kalantara 
class. 

§ It is a Mansa-Marma about half a finger in length and of the 
Kalantara class, (according to Vgabhata, of the Sadyo-Maraka class). 

II It is a S'ir^.Marma, half a finger in length, and of the Kalantara 
class. 

H It is a S'ira-Marma, half a finger in length and belongs to the 
Kalantara class. 



1 84 THE SUSHRUTA SAMHITA. [Chap. Vl. 

of the breast), fills the Koshtha with the deranged 
Vayu (tympanites) accomapanied by cough and dys- 
pepsia, and terminates in death. Thus the twelve 
Marmas situated in the thorax and abdomen are 
described. 55-56. 

PriShtha Marmas :— Now we shall discourse 
on the Marmas in the back (of a man). An injury to 
any of the Katika-tarunas* (sacro-iliac articulation), 
situated in the region of the S'roni Csacrum) on both 
sides of the spinal column, gives rise to an excessive 
haemorrhage and consequent pallor and ends in death. 
A hurt to any of the Kukundara Marmas | (lit : — a 
hollow — the great sacro-sciatic notch), situated on both 
sides of the spinal column and in the region slightly 
below the waist (in the loins), results in complete 
anaesthesia and inoperativeness of the lower extremi- 
ties. A hurt to the Nitamva-Marmas,| attached to 
the side above the Sroni (pelvis) and attached inside to 
the muscles of the waists, gives rise to Sosha (atrophia) 
in the lower extremities, weakness and ultimately brings 
on death. An injury to the PairsVa-Sandhi-Marmas § 
(caelic axes) which are situated just at the middle below 
the extremities of the sides (P^rsva) and which lies 
attached at the middle between the loins at their lower 
regions, feels the Koshtha (abdomen) with the blood 
and results into death A hurt to the Vrihati-Marmas 1] 

* It is an Aslhi-Marma, half a finger in length and of the Kalantara- 
maraka class. 

t They ate Joint-matmas (Sandhi), half a finger in length and of the 
Vaikalyakara group. 

J It is a bone Marma, half a finger in length, and of the Kalantara clas§, 

§ It is a S'ira-Marma to the length of half a finger and belongs to 
the Kalantara class. 

li They are S'ira-Marmas (arterial anestomsis) to the lengt of half 
a finger and belong to the KaUntara class. 



Chap. VI.J SARIRA STHANAM. iS$ 

which commencing from the roots of the breast 
course round both the sides of the spinal column 
(Pristha-vams'a), cause excessive bleeding, and the patient 
dies, as supervening symptoms arise from an excessive 
loss of blood. An injury to any of the two Amsa-phalaka» 
Marmas* situated on either side of the vertebral column 
and connected with the scapula brings on anesthesia 
or atrophy (Sopha) of the arms. There are two Marmas 
known as Amsa-Marmasf which are situated on either 
side midway between the neck and the head of the arms 
and connect the Amsa-Pitha (glenoid cavity) and the 
Skandha (shoulder). An injury to any of these Marmas 
is attended with an incapacity of moving the hands. 
Thus the fourteen Marmas in the back have been 
described. 57-65. 

The Jatrugata- Marmas :-Now we shall 

describe the Marmas which are situated in the regions 
above the clavicles (Urddhva-Jatru). There are four 
Dhamani (arteries) about the two sides of the Kantha- 
Nadi (wind-pipe). Two of them are known as Nilai, and 
the other two as Manyai. One Nild and one Manyd are 
situated on either side of the larynx, (i.e , anterior and 
posterior side of the larynxl An injury to any of them 
produces dumbness, and change of voice (hoarseness), 
and also the loss of the faculty of taste. | An injury to 
any of the eight Siras (arteries), four being on each side 
of the neck (Griva), and known as Sirak-Ma^trika- 
Marmas § ) ends fatally within the day. 65-69. 

* It is an Asthi-Marma, half a finger in length and is Vaikalyakara. 

t They are Snayu Marmas, half a finger in length and of the 
Vaikalyakara class. 

t They are S'ira-Marmas, to the lengrh of four fingers and of the 
Vaikalyakara class. 

§ They are S'ira-Marmas, four fingers in length and of the Sadyo- 
Matan class, 

24 



1 86 THE SUSHRUTA SAMHttA. [Chap. Vl. 

An injury to any of the two Marmas lying at the 
junction of the head and neck (Griva) and known as 
Krikaitikat* (transverse process of the arch of the atlas) 
results in a free movement of the head. A hurt to any 
of the Marmas attached to the lower end of an ear 
(posterior extrensic ligament) and known as the 
Vidhurat Marma results in the loss of hearing. An 
injury to the Phana-Marmast attached to the interior 
channels of both the nostrils, results in the loss of the 
faculty of smell. An injury to the Apaknga-Marmas § 
(Anastomosis of the infra-orbital artery) situated below 
the tips of the eye-brows and about the external corners 
of the eyes, brings on blindness or defective vision. An 
injury to the Avarta-Marmas 11 situated above and below 
the eye-brows, brings on blindness and impaired vision. 
An injury to the Sankha-MarmasIT (meeting or suture 
of the temporal, frontal and sphenoid bones — Pterion)^ 
situated over the tips of the eye-brows and between the 
ears and the forehead, results in death within the day. 
The Marmas situated over the two temples (Sankha) 
and at the border of the hair (sculp) are called Utkshepa- 
Marma (meeting of the posterior and anterior temporal 
arteries)$. An extraction of a shaft (Salya) or of any 

* They are Sandhi-Marmas, half a finger in length, and of the 
Vaikalyakara group. 

t It is a S'nayu-Marma, and is of the Vaikalyakara class. 

% They are S'ira-Marmas to the length of half a finger and of the 
Vaikalyakara class, 

§ They are S'ira Marmas to the length of half a finger and of the 
Vaikalyakara class. 

II They are Sandhi-Marmas, to the length of half a finger and of the 
Vaikalyakara class. 

^ They are Asthi-Marmas to the length of half a finger. 

$ They are S'ndyu-Marmas, half a finger in length and of the 
Vis'alyaghna class. 



Chap. V/. J SARIRA STHANAM. liy 

extraneous pointed thing lodged into these Marmas, 
results in the death of the patient, who, on the contrary, 
lives as long as the shaft is allowed to remain inside or 
if the shaft comes out itself (after putrefaction). 70-75. 
An injury to the Sthapani-Marma* (nasal arch of 
the frontal veins), situated in the middle of the eye- 
browSj ends in the manner of the preceding one. An 
injury Co any of the five joints of the head which are 
known as the Simanta-Marmast, results in fear, insensi- 
bility and madness of the patient and terminates in 
death. An injury to any of the four Sringaktaka- 
Marmas]: which forms the junction of the four Siras 
(nerves), (branches of the facial artery) and soothes the 
nose, the eyes, the ears and the tongue, proves fatal 
within the day. An injury to the A dhipati- Marmas § 
(the vertical groove on the frontal bone) which is marked 
in the inner side of the roof of the cranium by the Sifd- 
Sannipdta (superior longitudinal sinus), and on the 
exterior side by the ringlet of the hair (Romavarta) 
proves fatal within the day. Thus we have described 
the thirty-seven Marmas, situated in the region aboVe 
the clavicles (Urddhva-Jatru). 76-80. 

IVIeinorable Verses :— An incision should 

be made at the spot a fingers width remote from the 
Urvi, Kurchcha-Sir^, Vitapa, Kaksha and a Pdrsva- 
Marma ; whereas, a clear space of two fingers should 

* They are S'ira-Marmas to the length of half a finger and of the 
Visalyaghna class. 

t They are Sandhi-Marmas to the length of four fingers and of the 
Kalantara-Pranahara class. 

t They are S'ira-Marmas to the length of four fingers and of the 
Sadyah-Pranahara class. 

§ It is a Sandhi-Marma, half a finger in length and of the Sadyah- 
Pranahara class. 



1 88 THE SUSHRUTA SAMHITA . [Chap. VI. 

be avoided from its situation in making any incision 
about the Stanamula, Manivandha or Gulpha-Marma. 
Similarly a space of three fingers should be avoided 
from the Hridaya, Vasti, Kurchcha, Guda or Nabhi 
Marma ; and a space of four fingers should be avoided 
in respect of the four Sringatakas, five Simantas and 
ten Marmas in the neck (Nila etc.) ; a space of half 
a finger being the rule in respect of the remaining (fifty- 
six).* Men, versed in the science of surgery, have laid 
down the rule that, in a case of surgical operation, the 
situation and dimension of each local Marma should 
be first taken into account and the incision should be 
made in a way so as not to affect that particular Marma, 
inasmuch as an incision, even extending or affecting, 
in the least, the edge or the side of the Marma, may 
prove fatal. Hence all the Marma-Sthanas should be 
carefully avoided in a surgical operation. 8i. 

The amputation of a hand or a leg may not prove 
fatal whereas a wound in any of the Marmas situated 
therein is sure to bring on death. The vessels become 
contracted in the case of a cut in the leg or in the hand 
of a man, and hence the incidental bleeding is compara- 
tively scantier. Therefore it is that a cut in any of these 
parts of the body, however painful, does not necessarily 
prove fatal, like the lopping off of the branches of a 
tree. On the contrary, a man pierced into in any such 
Marmas, as the Kshipra or the Tala, suffers from excessive 

* Some are of opinion that a surgical operation (in the case of the 
remaining fifty-six) should be made, leaving a space equal in measurement 
to the dimensions of a palm (from the affected part). Gayadasa, having 
learnt from Bhoja, explains that a space of two fingers should be left (from 
the affected part) in making surgical operations of the ten marmas, namely, 
the two Gulphas, the roots of the two breasts, the four Indravastis, and the 
two Manivandhas. 



Chap. VI.] SARIRA STHANAM. 1 89 

hemorrhage (from the affected part) and attended with 
an excruciating pain, owing to the derangement of the 
Vdyu, and meets his doom like a tree whose roots 
have been severed. Hence, in a case of piercing or 
of injury to any of these Marmas, the hand or the leg 
should be immediately amputated at the wrist or at 
the ankle (respectively). 82. 

The medical authorities have described the Marmas 
to have covered half in the scope of Salya Tantra 
(Surgery), inasmuch as a person hurt in any of the 
Marmas dies presently (i. e., within seven days of the 
hurt). A deformity of the organ is sure to result from 
an injury to one of these Marmas, even if death be 
averted by a course of judicious and skillful medical 
treatment. 83. 

The life of the patient is not to be despaired of even 
in the case of fracture or crushing of a bone of the 
Koshtha, Sirah and Kapdla or perforation of the intestines 
etc , if the local Marmas are found not to be in any way 
hurt or affected. Recovery is common in cases of 
cuts (pierce) in the Sakthi, Bhuja, Pdda and Kara 
or in any other part of the body and even where a 
whole leg or hand is found to be severed and carried 
away if the Marmas are not in any way hurt or 
affected. 84. 

These Marmas form the primary seats of the Vayu, 
the Soma (lunar) and Tejas (fiery principles of the 
organism), as well as of the three fundamental qualities 
of Satva, Rajas and Tamas, and that is the reason why 
a man, hurt in any of the Marmas, does not live. 85. 

An injury to a Marmaof the Sadyah-Prdnahara class 
(in which death occurs within a day) is attended with 
the imperfection of the sense organs, loss of conscious- 
ness, bewilderment of Manah (mind) and Buddhi 



IQO THE SUSHRUTA SAMHITA. [Chap VI. 

(intellect) and .various kinds of pain. An injury to a 
Marma of the KAlantara group (of a person) is sure to 
be attended with the loss of Dbatus (blood etc.) and 
various kinds of supervening symptoms (Upadrava) which 
end in death. The body of a person, hurt in any of 
the Vaikalyakara Marmas, may remain operative only 
under a skillful medical treatment ; but a deformity 
of the affected organ is inevitable. An injury to any 
of the Vis'alyaghna Marmas ends in death for the 
reasons mentioned above. An injury to any of the 
Rujdkara Marmas gives rise to various kinds of pain 
in the affected organ, which may ultimately bring about 
a deformity of the same, if placed under the treatment 
of an ignorant and unskillful Vaidya (Surgeon). S6. 

An injury to the adjacent part of a Marma, whether 
incidental to a cut, incision, blow (Abhighdta), burn, 
puncture, or to any other cause exhibits the same 
series of symptoms as an actually affected one. An 
injury to a Marma, whether it be severe or slight, is 
sure to bring deformity or death.* Sy. 

The diseases which are seated in the Marmas, are 
generally serious, but they may be made to prove 
amenable with the greatest care and difficulty. 88-89. 

* Gayadasa does not read this verse. 

Thus ends the sixth Chapter of the S'arira Sthanam in the Sus'ruta 
Samhita, which treats of Marmas. 



CHAPTER VII. 

Now we shall discourse on the Siriram which treats 
of the description and classification of Sira or vascular 

system * ( ^irsL-Varnana-Vibhaktinama 
^ariram). 

There are seven hundred Sirds (vessels) in the 
human organism (except those which cannot be counted 
for their extremely attenuated size). The vessels 
(Siras) by their contractibility and expansibility &c , 
sustain and nourish the organism in the same manner 
as streamlets and canals serve to keep a field or a 
garden moist and fruitful. From the principal or cen- 
tral trunk hundreds of small and minute vessels branch 
off and spread all over the body, just as small or minute 
fibres are found to emanate from the large central vein 
of the leaf of a plant. They originate from the umbili- 
cal region and thence they spread all over the body up- 
wards and downwards and obliquely. 2. 

IVIemorable Verses :— All the Siras (vessels) 

that are found in the organisms of created beings, ori- 
ginate from the umbilical region (Nabhi)-)* and thence 
they spread all over their bodies. The life of an or- 
ganic animal is seated in the vessels surrounding its 
navel which forms their starting point. The navel in 
its turn rests on or is attached to the Pranas (the life- 
carrying vessels — nerves attached to it) in the same 

* The Sanskrita term S'ira denotes veins, nerves, arteries and lympha- 
tic vessels as well. Some read S'ird- Varna (different colours of the 
Siras) in lieu of S'ira-varnana (description of S'iras). 

t Most probably the idea is derive! from the appearance of the S'iras 
in their foetal state. 



192 THE SUSHRUTA SAMHITA. tChap. Vll. 

manner as the nave of a wheel supports the spokes, and 
the spokes in their turn support the nave. 3-4. 

Principal ^iraS:-Of these Siras (vessels), 
forty are principal ones, of which ten are Vayu-carrying 
Siras (nerves), ten are Pitta-carrying Siras (veins), ten 
convey Kapha (lymphatic vessels?) and ten are blood- 
carrying Siras (arteries). Of these the Vayu-carrying 
Siras, situated in the specific receptacle of that bodily 
principle (Vata), are again found to branch out in one 
hundred and seventy five smaller branches (ramifications). 
Similarly, each of the remaining Pitta-carrying, Kapha- 
carrying and blood-carrying vessels (Sirds) situated in 
their specific receptacles, {ie , in the receptacles of Pitta, 
Kapha and spleen and liver respectively) are found to 
branch out in as many numbers (one hundred and 
seventy-five), — thus making a total of seven hundred 
in all. 5. 

Their Specific Locations :- There are 

twenty-five Vayu-carrying Siras (nerves) in one leg and 
the same count applies to the other. Similarly there 
are twenty five Vatyu-carrying Siras (vessels) in each of 
the hands. There are thirty-four Vayu-carrying vc^ssels 
in the Koshtha trunk) ; of these eight occur in the pelvic 
regions attached with the anus and the penis ; two in 
each of the sides, six in the back, six in the Udara 
(cavity of the abdomen), and ten in the region of the 
chest. There are forty-one Vayu-carrying Sira's (ves- 
sels) situated in the region above the clavicles. Of 
these fourteen occur in the neck ; four in the two ears ; 
nine in the tongue ; six in the nose and eight in the 
two eyes. Thus we have finished the description of the 
one hundred and seventy-five Siras that carry Vayu. 6. 
What has been said of these Vayu-carrying vessels 
(Siras) will also hold good to the rest (in blood-carrying, 



Chap. VII.] SARIRA STHANAM. 193 

Pitta-carrying and Kapha-carrying channels in the res- 
pective regions of the body), with the exception that 
in these three cases, ( Pitta, Kapha and blood ) ten 
occur in the eyes and two in the ears in lieu of eight 
and four respectively, as in the case of VAyu-carrying 
Siris (vessels). Thus we have described the seven hun- 
dred Sirds with their branches. 7. 

Memorable Verses— The Vdyu-carrying 

Sirds : —The Vdyu in its normal state and coursing 
through its specific Siras (vessels) helps the unobstructed 
performance of its specific functions viz.^ expansion, 
contraction, speech, &c., and produces the clearness and 
non-illusivencss of Buddhi ( intellect ) and the sense- 
organs, whereas a coursing of the said Vayu in a de- 
ranged condition through the aforesaid Sirds (vessels), 
gives rise to a host of such diseases as are due to the 
derangement of Vdyu. 8. 

The Pitta-carrying ^iras:— The Pitta in 

its normal state and coursing through its specific S'iras 
(vessels) produces the healthy glow of complexion, 
relish for food, kindling of the appetite, healthfulnoss 
and other good effects, characteristic of the Pitta, which 
however being aggravated and coursing through them 
gives rise to a host of Pittaja diseases. 9. 

The Kapha-conveying firsts:— The 

Kapha in its normal state and coursing through its specific 
Sirds (vessels) smoothes and contributes to the firmne33 
of the limb3 and joints, improves the strength and pro- 
duces all other good effects specially belonging to it, 
whereas the same Kapha, flowing through them in an 
aggravated condition, ushers in a large number of the 
Kaphaja distempers of the body. 10. 

The Rakta-carryi ng ^i rsis : —The blood 

in its normal state and flowing through its specific S'irds 

25 



t94 THE SUSHRUTA SAMHITA. [Chap. VII. 

(vessels) strengthens the other fundamental principles 
(Dhatus) of the body, improves the complexion, aids 
the organ of touch in the proper performance of its 
functions and produces other functions characteristic of 
it in the body. Flowing through them in a vitiated 
condition, it begets diseases which are due to the de- 
rangement of the blood, ii. 

There is not a single Sira (vessel) in the body 
which carries either the Vayu, or the Pitta or the 
Kapha alone. Hence each of the vessels should be 
regarded as affording an opportunity for conveying all 
kinds of the Doshas of the body, for as soon as they are 
deranged and aggravated they seem to flow through all 
the Sirds promiscuously. Hence they are called Sarva- 
vahah. 12. 

Specific colours of the ^iras:-The 

vessels which carry the bodily Vayu (nerves) have a 
vermilion (yellowish red) hue and seem to be stuffed 
with Vdyu. The Pitta-carrying vessels (veins) are 
coloured blue and felt warm to the touch. The Kapha- 
carrying vessels are hard, cold to the touch and white- 
coloured. The blood-carrying vessels (arteries) are red 
and neither too hot, nor too cold. 13. 

Now we shall describe the Siras (veins) which a 
surgeon should not pierce or open, inasmuch as it may 
result in death, or bodily deformity. An intelligent 
surgeon shall always bear in mind that sixteen out of 
the four hundred vessels in the extremeties, thirty-two 
out of the hundred and thirty-six vessels in the trunk 
and fifty out of the sixty-four vessels in the region above 
the clavicles, should not be opened or bled on any 
account. 14-15- 

Of the one hundred vessels in a single leg, the one 
Jdla<ihard (which is attached to the connective tissue 



Chap, vn.] SARIRA STHANAM. ,lg5 

of the Kurchcha-Sirah) as well as the three internal 
ones, of which two are known as the Urvi- veins and the 
other as the Lohitiksha, together with the correspond- 
ing ones in the other leg and in the two hands, thus 
making sixteen in all, which are situated in the upper 
and lower extremeties, should be held unfit for opening. 
Of the thirty-two veins in the pelvic region (Sroni), eight 
such, known as the four)Vitapas (two on each side of the 
testicles) and the four known as the Katika-tarun as (two 
on each side) should be considered unfit for bleeding or 
opening. Of the sixteen veins (eight on each side) at the 
sides, the one which courses upward from each of the two 
sides and is attached to the Marma known as the Patrs'va- 
Sandhi, should be considered unfit for similar purposes. 
Of the twenty-four Siras which are found in either side 
of the spinal column, an incision should not be made 
into any of the two Siras (on each side) known as 
the Vrihati and which run upward along either side 
of it (spinal column). Similarly of the twenty-four Siras 
in the abdomen, the two along each of the two sides of 
symphis pubis should be held unfit for opening or 
bleeding. Of the forty veins in the chest, the two in the 
heart, two in the root of each breast and two in each 
of the Stana-rohita (muscle of the breast) and one in 
each of the Apastambhas and Apalapas, making fourteen 
in all, should not be opened. Thus thirty-two Siras in 
the regions of the back (i. e., the sides and the pelvic 
regions), the abdomen and the chest should be regarded 
as unfit for opening or other surgical purposes. 16—21. 
There are one hundred and sixty-four Sirds in the 
region above the clavicles. Of these the eight and four 
(making twelve and respectively known as the eight 
Matrikas, the two Nilas and the two Manyas) out 
of the fifty-six in the neck and the throat, should . be 



196 THE SUSHRUTA SAMHITA. tChap. Vll. 

regarded as unfit for opening. Similarly the two veins 
in the two Krik^tikds and two in the two Vidhuras, 
should be held unfit for similar purposes ; thus making 
sixteen in all in the neck. Of the sixteen vessels (eight 
on each side) of the Hanus (Jaws), the two Siras about 
each of the joint of the jaw-bones should never be 
opened. 22. 

Of the thirty-six* vessels in the tongue, sixteen are 
situated in the under-surface of that organ and twenty 
in the upper surface ; of these the two speech-carrying 
and the two taste-carrying ones should be held unfit for 
venesection. Of the twenty-four vessels in the nose, 
the four adjacent to the nose proper and the one running 
into the soft palate should be held unfit for similar 
purposes. Of the thirty-eight vessels in the two eyes, 
the one situated at each Apanga should not be 
opened. Of the ten vessels in the two ears, the sound- 
carrying one in either ear should not be opened. Of 
the sixty vessels of the nose and eyes coursing 
through the region of the forehead, the four vessels 
adjacent to the sculp proper and the Avarta-Marma 
should be held unfit for opening or bleeding. One 
vessel (Sird) in each of the two Avartas and the one in 
the Sthapani-marma should not be opened (on any 
account). Of the ten vessels in the temple, the one 
about each temple-joint should be held unfit for opening 
or bleeding. Of the twelve vessels in the head, the one 

*Gayi asserts that there are eight each of the Vayu-carrying, Pitta- 
Carrying, Kapha-carrying and blood-carrying S'iras in the region of the 
neck, thus making a total of 32 in place of 36 of the text. 

He also holds that there are 28 in place of 36 S'irds in the tongue, 
16 in place of 24 in the nose, 24 in place of 38 in the eyes, 16 in place of 
10 in the ears and 8 in place of 10 in the temple. In the counting of the 
S'iras situate in the other parts of the body, he, however, does not differ 
fiom the text. 



Chap. Vlt] SARIRA STHANAM. TQ; 

in each of the two Utkshepa-Marmas, one in each of the 
(five) Simanta-Marmas and one in the Adhipati-Marma, 
should be held unfit for the purpose. No incision or 
opening should be made into any of these fifty vessels 
situated in the region above the clavicles. 23-31. 

Memorable verses :— As the stem and leaves 
etc, of a lotus plant, originated from its bulb, spread 
over the whole surface of a pool or tank (lit : water), 
so the vessels emanating from the umbilicus of a man 
spread over his whole organism. 32. 

Thus ends the seventh Chapter of the S'arira Slhanam in the 
Sus ruta Samhila which treats of the description and classification of 
S'iras (vessels). 



CHAPTER VIII. 

Now we shall discourse on the Sariram which treats 
of the method of Venesection etc. (^ira-Vyadha- 

Vidhi-^ariram). i 

Persons unfit for Venesection:— The 

vessel or vessels (Sira) of an infant, an old man, a per- 
ched man, one fatigued and emaciated with endocarditis 
(Kshata-kshina), a person of timid or coward disposition, 
a person used up with excessive drinking or sexual 
enjoyments or tired with the troubles of long journey, 
an intoxicated person, a patient who has been treated 
with purgatives, emetics or with Anub^isana and 
Asthdpana measures (enemas), a man who has passed 
a sleepless night, an impotent (Kliva) or emaciated person, 
an enceinte, or one afflicted with cough, asthma, high 
fever, phthisis convulsions, paralysis, thirst, epilepsy, 
or effects of fasting, should not be pierced or opened. 
Incisions should not be made into those veins (Siras) 
which are not fit for opening, or into the fit ones, if 
invisible ; it should be the same with those which cannot 
be properly ligatured or even if ligatured cannot be 
raised up. 2. 

Diseases which are amenable to acts of venesection 
have been described before (Sonita-Varnaniya-Adhydya). 
Venesection may be performed in the said diseases as 
well as in those which have not been enumerated in 
connection with them and also in other cases whether 
suppurated or unsuppurated, if such a proceeding is 
deemed necessary and after the application of Sneha and 
Sveda. Venesection should be made even in the cases 
declared unfit for it (such as in an infant etc.) in cases of 



Chap. VIII.] SARIRA STHANAM. 1 99 

blood-poisoning (such as snake-bite etc.) and in fatal 
diseases (Vidradhi etc.). 3-4. 

Preliminary rules : —The patient should be 

duly fomented i^Sveda) atid anointed (Sneha) with oily 
preparations. A liquid* food or diet consisting of articles 
which are antidotal to the bodily principles (Doshas) 
which engendered the disease or Yavagu (gruel) should 
be given to him at first. Then at the proper season (i.e., 
not in the rainy or winter season etc.) the patient should 
be brought near the surgeon and made to sit or lie down 
and the part to be incised upon should be bound, neither 
too loosely {e.g., in the extremities etc.) nor too tightly 
(^.^.,in the head etc.), with any of the accessories, such as 
cloth, linen, skin, the inner fibres of a bark, creepers etc., 
so as not to create any pain or agitation in his mind. 
Then the vein should be duly opened with proper instru- 
ment (and with a careful regard to the situation of any 
local Marma). 5 

IVletrical text : —Venesection should not be 
performed in an extremely cold or hot, cloudy or windy 
day. It is forbidden to open a vein without necessity 
or in a healthy person, or in a disease in which such as a 
proceeding is absolutely prohibited. 6. 

The Yantra-Vidhi :— The patient whose 
vein is to be operated upon should be seated on a stool 
to the height of an Aratni (distance of the elbow from 
the tip of the small finger) with his face turned towards 
the sun. He should keep his legs in a drawn up or 
contracted posture resting his elbows (Kurpara) on his 
knee-joints and the hands with his two thumbs closed 
in his fists placed on (the upper ends of; his Manyas 
(sterno mastoid muscles), Then having cast the binding 

* A liquid food is recommended for the purpose of liquefying the 
blood so as to bleed easily. . . - 



200 THE SUSHRUTA SAMHITA. [Chap. VIII. 

linen on the two closed fists thus placed on the neck, the 
surgeon should ask another man from the back side of 
the patient to take hold of the two ends of the cloth 
with his left hand having the palm turned upward, and 
then ask him to tie up with his right hand the bandage 
round the part, neither too diffusely nor too tightly nor 
too loosely, so as to raise the vein and to press the 
bandage round the back for a good out-flow of 
blood. Then he (surgeon) should perform the operation 
in the desired spot, the patient having been previously 
asked to sit with his mouth full of air {i.e., he should 
confine his breathing till the surgical operation is com- 
pleted). This proceeding should be adopted in opening 
any vein of the head, save those which are situated in the 
cavity of the mouth . 7. 

In the case of opening a vein (Sird) in the leg, the 
affected leg should be placed on a level ground, while 
the other leg should be held in a somewhat contracted 
posture, at a little higher place. The affected leg should 
be bound with a piece of linen below its knee-joint 
and pressed with the hands down to the ankle. A liga- 
ture of the above kind should then be tied four fingers 
above the region to be incised upon, after which the 
vein should be opened. 8. 

In the case of opening a vein (Sira) in the arms, 
the patient should be caused to sit easily and fixedly 
with his two thumbs closed in his fists (as above). 
A ligature ol the above-mentioned kind (rope etc.,) 
should be tied (four fingers above the part to be incised 
upon and the vein opened in the aforesaid manner. 
The knee-joint and the elbow should be held in a 
contracted or drawn up posture at the time of opening 
a vein in a case of Gridhrasi (Sciatica^ and Vis'vachi, 
respectively. The patient should hold his back raised 



Chap. Vlli.] SARTRA STIIANAM. 201 

up and expanded and his h^ad (and shoulders) bent down 
at the time of opening a vein in the back, shoulders and 
the Sroni (hips). He should hold his head thrust back 
and his chest and body expanded at the time of open- 
ing a vein in the chest or in the abdomen. 9-12. 

He shall embrace his own body with his arms at the 
time of opening a vein in his sides. The penis should 
be drawn downward (2>., in an flaccid state) on a 
similar occasion in that region. The tongue should be 
raised up to the roof of the mouth and its fore-part 
supported by the teeth at the time of opening a vein in 
its under-surface. The patient should be told to keep his 
mouth fully open at the tim^ of opening a vein in the 
gums or in the palate. Similarly a Surgeon should devise 
proper and adequate means for the purpose of raising 
up (distinct appearance of) a Sira (vein) and determine 
the nature of the bandao'e to be used therein accordinor 
to the exigencies {i.e., the health and the kind of diseases 
of the patient), of each case. 1 3-17. 

An incision to the depth of a barley-corn should be 
made with a Vrihimukha instrument (Into a vein 
situated) in the muscular parts of the body, whereas the 
instrument should b3 thrust oily half that depth or to 
the depth of a Vriki seed in other places (Vrihi here 
signifies S'likadkdnya as well as Rakta-s':ali\ An inci- 
sion over a bone should be made with the Kutharikd 
(small surgical axe) to the half depth of a barley- 
corn. 18-19. 

IVIemorable Verses :— An opening should 

be effected in such a day in the rainy season as would 
be devoid of the rumblings of a thunder-cloud, during 
the cold (2>., in the fourth) part of the day in summer, 
and at noon in the winter season (Hemanta). These 
are the only three times of opening a vein. A well 

26 



202 TiiE SIJSHRUTA SAMHITA. [Chap. VIII. 

and successfully pierced vein bleeds in streams (almost 
simultaneously with the thrusting of the knife) and 
spontaneously stops after a Muhurta (a little while). The 
vitiated blood is seen first to flow out of an opened 
vein, like the drop of yellow pigment first coming out of 
a Kusumhha flower. Blood does not flow out from an in- 
cision made into a vein of an unconscious (Murchchhita), 
much frightened, or a thirsty patient. An incision of a 
vein without proper bandaging and raising up is attend- 
ed with a similar result. 20-23. 

A weak person, or one afi"ected with the unusual 
derangement of the bodily Doshas etc., or one fainted 
(under operation), should not be subjected to a measure 
of continuous blood-letting at a time ; instead of that, 
the vein should be opened afresh in the same afternoon 
or on the following day, or on the third day (as the exi- 
gency requires). An intelligent surgeon should not 
allow the flow of blood to an excess but should stop 
the flow even with a remnant of the diseased blood in 
the system and administer soothing internal remedies 
(Samsamana) for the purification of the diseased rem- 
nant. Bleeding to the quantity of a Prastha* measure 
should be deemed sufficient for a strong and adult patient, 
stuffed with a large quantity of the deranged Doshas (in 
the body). 24-26. 

The vein should be incised with a Vrihimukha instru- 
ment at a distance of two fingers above the seat 
of the Kshipra-marma in such diseases as Padadaha, 
Pada-harsha, Ava-vahuka, Chippa, Visarpa, Vata-rakta, 
Vdta-kantaka, Vicharchika, Padadari etc. The mode 
of opening a vein in the case of Slipada (Elephantiasis) 

* In medicinal preparalions, a Praslha measure is understood to be 
four seers in the case of liquids, but in Cises of excreta due to emetic and 
purgative measures and of blood-lettiDg, a Prastha m meant to be 
thirteen Palas and a half only. 



[Chap. VIII, SARIRA STHANAM, 



203 



would b2 described under the treatment of that disease. 
In Vata-rogas, such as Kroshtuka-s'irah (Synovites), 
maimedness (Pangu) and lameness (Khanja\ the Siia 
(vein) of the Jangha (lower leg-calf), four fingers above 
the Gulpha, should be opened. In cases of Apachi 
(scrofula), the vein should be opened simultaneously with 
the appearance of the disease two fingers below the 
Indravasti-marma. In a case of Gridhrasi (sciatica), 
the vein should be opened four fingers above or below 
the Jdnu (knee-joint). In a case of goitre, the veins 
attached to the roots of the Uru (thighs) should be 
opened. The instructions regarding the opening of a 
vein in one leg shall hold good in the case of that in 
the other, as well as in cases of those situated in the 
two upper extremities (hands), but the speciality is that 
in a case of enlarged spleen, the vein near the Kurpara- 
sandhi (elbow-joint) of the left hand or that inside the 
fourth and the fifth fingers should be opened. Similarly 
in a case of Yakriddalyodara or Kaphodara, the corres- 
ponding vein in the right hand should be opened. 
Several authorities advise the opening of the same vein 
in cases of cough and asthma* due to the action of the 
deranged Kapha. 27-35. 

In a case of Vis'vachi, the same argument holds good 
(four fingers above or below the Kurpara-sandhi) as in 
a case of Gridhrasi. In a case of Pravdhikd (diarrhoea) 
attended with Sula (colic), the vein within two fingers 
width around of the Pelvis (Sroni) should be opened. 
The vein of the penis should be opened in a case of 
Parikartikd (D.R.-ParivartikA), Upadansa, Suka-dosha 
and seminal disorders. The vein on either side of 

* Gayi holds that in cases of asthma and cough venesection should 
be had recourse to only when they are in a mild form. 



204 THE SUSHRUTA SAMHITA. Chap. VIII.] 

the scrotum should be opened in a case of hydrocele 
(Mutra-Vriddhi). 36-39. 

The veui four fingers below the navel and on the 
left side of the Sevani (suture) should be opened in a 
case of Dakodara (ascites). In a case of internal 
abscess and colic in the sides (Pleurodynia), the vein in 
the region between the breast and the left armpit 
should be opened. Several authorities assert that in a 
case of Avavahuka and Vahusosha (atrophy of the hand), 
the vein between the Amsas (shoulders) should be 
opened. In a case of Tritiyaka (Tertian) fever^ the vein 
inside the Trika-Sandhi should be opened. In a case 
of Chaturthaka fever, a vein jo hied with either side of 
and below the shoulder-joint should be opened. In a 
case of Apasmara, the middle vein adjacent to the joint 
of the jaw-bones (Hanu-Sandhi) should be opened. In 
a case of insanity and hysteria* (Apasmara), the vein 
between the temple and the edge of the sculp or those 
in the Apanga (tips of the eyes), the forehead or the 
chest should be opened. In cases of the diseases of the 
tongue and the teeth, the veins on the under-surface 
(Adho-Jihva) of the tongue should be opened. In 
the case of a disease of the palate, the local vein should 
be opened. In diseases of the ears and specially in 
a case of inflammatory ear-ache (Karna-Sula), the vein 
along the region above the ears should be opened. In 
diseases of the nose and specially in a case of the loss 
of the smelling faculty, the vein at the tip of the nose 
should be opened. In cases of eye-diseases, such as 

* Dallana, however, differs here from the text. He says, on the 
authority of Vagbhata, that the opening of a vein between the temple and 
the edgt of the sculp or those in the Apanga, the forehead and the chest 
should te recommended in cases of insanity only, and not in the case of 
of .^pas^mdra as well (as in the text). 



Chap. VIII.] SARIRA STHANAxM. 205 

Timira (blindness), Akshipdka (ophthalmia) etc., as well 
as In diseases of the head and in Adhimantha, the veins 
about the nose, the forehead and the Apdnga (the 
outer canthus of the eyes), should be opened. 40-51. 

Defective Venesection :— Now we shall 

describe the twenty kinds of defects relating to an 
opened vein (Dushta-vyadhana;. They are as follows : — 
Durviddha, Atividdha, Kunchita, Pichchita, Kuttita, 
Aprasrutd, AtyudirnA, Ante-abhihata, Parisushka, 
Kunita, Vepita, Anutthita-viddhd, Sastrahata, Tiryag- 
viddhd, Apavlddlia, Avy^dhyd, Vidrutd, Dhenukd, 
Punhpunarviddha and Marmaviddha, i.e., incised about 
the Sira-marma, the Sn^yu-marma, the Asthi-marma 
and the Sandhi-marma. 52-53. 

Their definitions :— The vein in which an 
act of venesection is unattended with a satisfactory 
outflow of blood owing to its being incised with an 
extremely slender instrument and is marked by an 
extremely painful swelling in consequence thereof, is 
called Durviddhat (badly incised). The vein in which 
the incision becomes excessive and no blood comes out 
properly or enters an internal channel owing to the 
largeness of the incision, is called Atividdha^ (over-in- 
cised). An opened vein in which the incision has been 
made in a curving manner and is attended with the fore- 
going results, is called Kunchitai (crooked or contracted). 
An incised vein presenting a flattened or thrashed ap- 
pearance on account of its being opened with a blunt 
knife (Kantha-Sastra) is called Pichchitai (thrashed). 
The vein at the sides of which incisions have been 
successively made, instead of in its body, is called 
Kuttitat (lacerated). An incised vein, unattended with 
any bleeding owing to the patient's fright, coldness or 
loss of consciousness, is called Aprasrulai (unbleeding). 



2o6 THE SUSHRUTA SAMHITA. [Chap. VIII. 

A vein with a large incision in its body made with 
a sharp and flat-edged instrument, is called Atyudirnat 
(improperly wide-incised). An opened vein in which 
blood oozes out in small quantity is called Ante- 
abhihatat (struck in the interior). An opened vein 
in an anaemic patient (marked by a total absence 
of bleeding and) stuffed with Vayu (lit., as if the 
flow has been dried up by the Vayu), is called 
Paris'ashkaL (dried up). A vein opened but to a quarter 
part of the proper length and attended with a scanty 
outflow of blood, is called Kunitai (partially incised). A 
vein which trembles owing to its being bandaged at a 
wrong place and from which blood does not flow out 
in consequence, is called VepitaL (quivering i. A vein 
incised without being previously properly raised up and 
attended with a similar result (ie., absence of blood), is 
called Auutthita-viddha^. A vein cut into two and 
attended with excessive bleeding and inoperativeness 
of the organ is called Sastrahata' (knife-cut). A vein 
incised with an instrument applied slantingly and 
(consequently) not fully opened, is called Tiryagf-viddha' 
(obliquely incised), A vein incised several times 
and (every time) with an improper instrument, is called 
Apaviddhat (wrongly incised) A vein unfit for opening 
{i,e., whose opening has been forbidden in the Sastras\ 
is called Avyskdhyai (unfit for opening), A vein opened 
carelessly and hastily is called Vidrutai (erratic). A 
vein bleeding continuously owing to its being repeatedly 
pressed and successively opened, is called Dhenuksi. 
A vein variously cut owing to its being pierced into 
the same part with an extremely slender-pointed instru- 
ment, is called Panah-punarvidahsi (repeatedly incised). 
If a vein in the Sn^yu-marmas, the Asthi-marmas, the 
SirA-marmas or the Sandhi-marmas be opened, it is 



Chap. Vllt.] SARtRA STIIANAM. 20/ 

called Marma-viddhai and in such cases severe pain, 
emaciation (Sosha) deformity or (even) death may be 
the result. 54. 

Memorable Verses : —Practice (even) docs 

not give the necessary skill in surgical operation of the 
veins etc., as they are naturally unsteady and changing 
like fishes. Hence a vein should be opened with the 
greatest care. An opening into the body, made by an 
ignorant and unskilful surgeon, is attended with the 
aforesaid dangers and many other distresshig symptoms. 
An act of venesection, properly performed, gives more 
speedy relief than that derived from the application of 
medicated oil &c., or of plaster as well. Venesection 
(bleeding) properly performed is half of the treatment 
described in surgery like the application of Vasti- 
karmas (enematic measures) in therapeutics. 55. 

A man medically anointed (Sneha-karma), diapho- 
rised (Sveda\ vomited (Vamana), purged (Virechana), 
or treated with both the Vasti-karmas (Anuvasana and 
Asthdpana) or bled shall forego anger, physical labour, 
sexual intercourse, sleep in the day time, excessive 
talking, physical exercises, riding or driving etc., sitting 
on his haunches, frequent ramblings, exposure to cold, 
winds and the sun, hardly digestible, uncongenial and 
incompatible food until the strength is perfectly restored 
or, according to some authorities, for a month. These 
subjects will be fully dealt with later on Aturopa- 
drava-chikitsa, ch. — 39). 56. 

Memorable Verses :— The vitiated blood 

incarcerated in any part of the body should be abstract- 
ed therefrom by scarifying it, by cupping it with a 
Sira (pipe), a horn, a gourd, or leeches, or by the opening 
of a vein respectively, according to the density of the 
blood. (Others assert that) leeches should be applied in 



208 THE SUSHRUTA SAMHITA. [Chap. Vlll. 

the case of the (vitiated) blood being confined deep 
into the body, scarification with a surgical instrument 
should be made in the case of clotted blood, with a pipe 
in the case of extensive vitiation of the blood through- 
out the body and with a horn or a gourd in the 
case of the deranged blood having been seated in the 
skin. 57-58. 

Thus ends the eighth Chapter of the S'arira Sihanam in the Sus'ruta 
Samhita which treats of venesection. 



CHAPTER IX. 

Now we shall discourse on the Sctriram which treats 
of the description of the arteries, nerves and ducts, etc.* 

(Dhamani-Vyakarana-^ariram). r. 

There are twenty-four Uhamanies (ducts) in all, and 
all of them have their origins in the naval region 
(which includes the whole abdominal region*|-). Several 
authorities assert that no arbitrary distinctions should 
be made among the Siras (veins), Dhaman is (arteries), 
and the Srotas, (channels), since Dhamanis and Srotas 
are but different modifications of one original kind 
of Sira (vessels). But this opinion is not a sound one 
inasmuch as they have got different natures, origins 
and functions and as being described so in the Ayurveda. 
But owing to their adjacent positions, the existence 
of several authoritative dicta (Apta-vak) regarding the 
oneness of their character, similarity of their functions, 
and the minute nature of their shape, they appear to 
be homologous in their action, even amidst the real 
diversities in their work and office. 2. 

Of the twenty-four Dhamanis, which (originally) 
have their roots in the naval region (Nabhi), ten 
have upward course, ten have downward course, and 
four flow laterally or transversely. 3. 

Functions of the up-coursing Dha- 
manis: — The ten up-coursing Dhamanis (nerves) 

* Sans. Dhama— to be filled with air, so called from the fact 
of their being distended with air after death. 

t So far, as in foetal' life, allantoic arteries and ihe unbilical veins 
subserve the purposes of nutrition, excretion, etc , and reflects the rudi- 
mentary vascular system. 

2; 



210 THE SUSHRUtA SAMHITA. [Chap. IX. 

perform such specific functions of the body, as sound, 
touch, taste, sight, smell, inspiration, sighing, yawning, 
sneezing, laughter, speech, and weeping, etc., and tend to 
maintain the integrity of the body. These Dhamanis, 
reaching the heart, respectively ramify themselves into 
three branches, thus making thirty (ramifications in all). 
Ten of these serve the following purposes, viz , two serve 
as the channels of the bodily Vayu, two of the Pitta, 
two of the Kapha, two of the blood, and two of the 
Rasa (lymph chyle). Eight of the remaining ones 
(twenty), serve the following functions, viz.^ two of them 
cany sound, two sight or colour, two smell, and two 
taste. Moreover a man speaks with the help of another 
two, makes sound with the help of another couple, 
sleeps through the instrumentality of another pair 
(couple), and wakes up with the help of another couple. 
Two of the Dhamanis (ducts) carry the fluid of lachry- 
mation, two of them (ducts), attached to the breasts 
of a woman, cany milk of her breasts, which, coursing 
through the breast of a man, convey his seminal fluid. 
Thus we have described the thirty Dhamanis with 
their ramifications. These sustain and maintain the 
integrity (of the limbs and members of the body) above 
the (line of) umbilicus, such as the Udara, the sides, 
the back, the chest, the neck, the shoulders and the 
arms. 4. 

IVIcmorabIcVcrSe:—Theup-coursing Dhama- 
nis duly perform the offices stated above. Now I 
shall describe the specific functions, etc., {i.e,, nature, 
office, and situations, etc.,) of the down-coursing ones. 5. 

Functions of the down -coursing 

Dhamanis : — The down-coursing Dhamanis res- 
pectively form the channels for the downward conveyance 
of Vayu (flatus), urine, stool, semen, and catamenial 



Chap. IX.] SARIRA STHANAM. 211 

fluid, etc. These Dhamanis reaching down into the 
PittAsaya (receptacle of the Pitta) separate the serum 
prepared out of the food and drink through the agency 
of the local heat (and pitta), and carry it to the remotest 
parts of the organism maintaining their healthy 
moisture, supplying them with the necessary principles 
of nutrition and (ultimately) conveying them to the up- 
coursing and lateral Dhamanis, in order to be conveyed 
to the parts traversed by them respectively. Thus they 
indirectly serve to supply the heart with its quota of 
healthy Rasa (serus fluid), if not in a direct way. Moreover 
they tend to separate the efifetematter (urine, stool and 
sweat) from the fully transformed lymph-chyle in the 
abdomen, the stomach and the small intestines (Amds'aya 
and Pakvas'aya). Each of the down-coursing Dhamanis 
is found to ramify into three branches at a place midway 
between the Amas'aya (stomach) and the Pakvds'aya 
(intestines). Thus they number thirty in all. The 
functions of the ten out of these (thirty vessels) are as 
follows, viz., two serve to carry Vdyu, two Pitta, two 
Kapha, two blood, and two Rasa (lymph-chyle). Two of 
these Dhamanis, running into the intestines, carry the 
food, another two carry the Toya* (watery) part, another 
two, running into the bladder, serve to carry out the 
urine (from the bladder), another two carry the semen, 
and another two serve as the channels of transmission 
and emission of the same fluid and serve to carry the 
ovarian discharge in women. The two Dhamanis, attached 
to the large intestine (Sthulantra), serve as the channels 
of faecal matter, while the remaining eight convey 
perspiration to the lateral-coursing Dhamanis, Thus we 
have finished describing these thirty Dhamanis with 
their ramifications. These sustain and maintain the 
* Xhi,s watery p^rt reaching the bladder is tKansformed into urine, 



212 THE SUSHRUTA SAMHITA. [Chap. IX. 

integrity of the parts of the body below the naval 
region, such as the Pakvasaya (Intestine), the waist, the 
organic principles of stool and urine, the organs of 
generation, the anus, the bladder, and the lower limbs of 
the body (Sakthi) (according to their utility in the 
physical economy of the organism). 6. 

Memorable Verse ;— These down-coursing 

Dhamanis perform the afore-said functions. Now I 
shall describe the specific functions {i.e., nature, office, 
and situations, etc.,) of the lateral-coursing Dhamanis. 7. 

Functions of the lateral-coursing* 

Dhamanis: — The four lateral-coursing Dhamanis, 
gradually ramifying themselves into hundreds and 
thousands of branches, simply baffle counting. The 
net-work of these Dhamanis spreads over the whole 
orgnism and maintain its integrity. Their exterior 
orifices are attached to the roots of hairs (pores of the 
skin) through which they convey the perspiration and 
the Rasa (serum), thus supplying the body, both inter- 
nally and externally, with the soothing nutritions 
(moisture of healthy lymph-chyle). The effects and 
potencies of the articles of anointment, sprinkling, 
immersion, and plasters, enter through these orifices 
into the internal organism through the agency of the 
heat in the skin, and sensations of a pleasant or 
painful contact are experienced through their instru-: 
mentality. Thus we have finished describing the four 
lateral-coursing Dhamanis with their ramifications 
throughout the whole organism. 8. 

Memorable Verses :— The Dhamanis have 
got pores in their sides through which they carry 
the Rasa (lymph-chyle) throughout the organism, like 
the filaments and fibres of water-lily and lotus. The.'^e 
Phan\anis furnish the self-conscious Ego, confined in 



I 



Chap. IX.] SARIRA STHANAM. 21 3 

the material body, which is the resultant of the combi- 
nation of the five material elements, with a distinct 
sensation* peculiar to each of the five sense-organsf 
and break up the combination (of the five material 
elements) at the time of death. 9 — 10. 

Now we shall describe the symptoms produced by a 
Srota (duct or channel) pierced at its root or starting 
point. The ducts or channels respectively conveying 
the life, the food, the water, (the organic principle of) 
the Rasa (serum), the blood, the muscles, the fat, 
the urine, the stool, the semen, and the cata- 
menial blood, naturally fall within the scope of 
Surgery (Salya-tantra). Several authorities assert that 
the Srotas (vessels) are innumerable]:, and perform 
different functions in their different aspects. 

The two Srotas (channels) of Prana (bronchi) have 
their roots in the heart and the Rasa-carrying Dhama- 
nis (pulmonary arteries). An injury to any of these 
Srotas (vessels) produces groaning, bending down of 
the body, loss of consciousness (Moha), illusion, and 
shivering, or may ultimately prove fatal. The food- 
carrying Srotas (^Esophagus) have their roots in the 
Amasaya (stomach) and in the food-carrying Dhamanis 
(intestines). An injury to or piercing of such a duct 
(Srota), gives rise to tympanites, colic pain, aversion to 
food, vomiting, thirst, blindness or darkness of vision, or 
may even end in death. There are two water-carrying 
(Udaka-vaha) ducts or channels which have their roots 
in the palate and the Kloma^ and a pie-cing of any 

* Hearing, touch, smell, taste, and sight. 

t Eyes, ears, nose, tongue and skin. 

t But this science does not take any cognisance of them, since the 
pain incidental to a piercing of, or an injury to, any of these extremely 
attenuated channels, tnust be slight in its character. 



214 THE SUSHRUTA SAMHITA. [Chap. IX. 

of these makes the patient thirsty and ends in his instan- 
taneous death (/. e , within seven days). The serum- 
carrying (Rasa-vaha) ducts are two in number and 
have their roots in (the viscus of) the heart and the 
serum-carrying Dhamanis (vessels). An injury to or 
piercing of any of these ducts gives rise to Sosha (con- 
sumption) and symptoms identical with those developed 
by a hurt to the Prana-vaha channels of the body, 
ending in death. The blood-carrying Srotas (channels) 
are two in number and have their roots in the spleen and 
the liver, and the blood-carrying Dhamanis (capillaries 
in general). An injury to any of these channels is 
attended with pallor, bluishness of complexion, fever, 
burning sensations, excessive haemorrhage, and redness 
of the eyes. The two muscle-carrying Srotas (ducts or 
channels) have their roots in the (Sndyu), nerves 
Tvak (serum), and the blood-carrying Dhamanis 
(capillaries). An injury to any of these channels is 
characterised by swelling, loss or atrophy of the muscles, 
appearance of varicose veins or may (ultimately) resu't 
in death. The fat-carrying Srotas (ducts) are two in 
number and have their roots in the region of the Kati 
(waist) and the Vrikkas (kidneys). An injury to any 
of these bring in (a copious flow of) perspiration, oily 
gloss of the skin, parched condition of the palate, 
extensive swelling (of the affected locality) and thirst. 
The two urine-carrying Srotas (channels) have their 
roots in the bladder and the penis (urethra). An injury 
to any of these is marked by constipation or epistaxis 
in the bladder, retention of urine, and numbness of the 
genitals. The two stool-carrying Srotas (ducts) have 
their roots in the Guda (anus) and the Pakvas'aya 
(intestines) ; an injuiy to any of these is characterised 
by complete retention of st;ool (in the bo\vels), accom- 



Chap. I)?.] SARIRA STHANAM. ^I5 

panied by a distention of the abdomen, foul smell and 
intussusception of the intestine (as in a case of ententes). 
The two semen-carrying Srotas (ducts) have their 
roots in the breasts and the testes. An injury to any 
of them leads to loss of manhood, delayed emission 
of semen, or blood-streaked character of that 
fluid. The two Artava- carrying Srotas (ducts) have 
their roots in the uterus as well as in the Dham.anis 
which carry the Artava (ovarian product). An injury 
to any of these brings on sterility, suppression of 
the menses and incapacity for copulation. A cutting 
to the Sevan! (median raphe of the perineum) exhibits 
symptoms identical with those of a case of injured 
bladder or anus, described before. A physician may 
take in hand the medical treatment of a case of a Srota 
which has been pierced, but he shall not necessarily 
entertain any hope of ultimate success. (But time 
works wonders, and such a case may sometimes end in 
recovery). A case of pierced duct, from which the 
dart (Salya, or the like piercing matter) has been 
extricated, may be medically treated (without holding 
out any prospect of recovery to the friends of the 
patient), according to the direction laid down under 
the head of ulcer (^Vrana). 11-12. 

IVIetrical Text :— The ducts emanating from the 
cavity of the heart, other than the Siras (veins), Dhaman is 
(arteries), and found to course through the whole body, 
are called Srotas (lit. channels or currents). 13. 

Thus ends the ninth Chapter of the S'arira Sthanam in the 
Sus'ruta Samhita which treats of the descriptions of the arteries, 
cucts and nerves. 



CHAPTER X. 

Now we shall discourse on the Sdriram which treats 
of the nursing and management, etc., of pregnant 
women from the day of conception till parturition 

(Garbhini-Vyakarana-^ariram). i. 

General Rules :— An cnciente, from the first 
day of conception, should always cherish a clear joy- 
ful spirit in a clem body. She should wear clean and 
white garments, ornaments, &c., engage herself in the 
doing of peace-giving and benedictory rites and live in 
devotion to the gods, the Brahmins and her elders and 
superiors. She should not touch nor come into contact 
with unclean, deformed or maimed persons, and should 
forego the use of fetid smelling things, avoid dreadful 
sights and painful or agitating sounds and the use of 
dry, stale and dirty food as well as that prepared 
overnight. Long and distant walks from home, resorts 
to cremation-grounds or to a solitary retreat, or to a 
Chaitya*, and sitting under the shadow of a tree should 
be absolutely forbidden (to her during the period of 
gestation). Indulgence in anger, fright or other agita- 
ting emotions of the mind should be deemed injurious. 
To carry a hea vy load, to talk in a loud voice and 
all other things which might occasion injury to the 
foetus, (sexual intercourse, &c.) should be refrained from. 
The practice of constant anointment and the cleansing 
of the body, &c., (with Amalaki, Haridrd, etc. —lit. cos- 
metics) should be given up, All fatiguing exercises 
should be discontinued and the rules laid down for the 

* Chaitya — is a haunted or diefied tree, or according to others a 
Budhistic monastery. 



Chap. X.] SARIRA STHANAM. 



217 



guidance of a woman in her menses should be strictly 
adhered to. The couch and the bed of a pregnant 
woman should be low, soft and guarded on all sides by 
a number of soft pillows or cushions. The food should 
be amply sweet, palatable (Hridya)* well-cooked, pre- 
pared with appetising drugs and abounding in fluid 
substances. These rules should be followed up till 
delivery. 2. 

Special regimen during the period 

of Gestation : -During the first three months of 
pregnancy an enciente should partake of food abound- 
ing in sweet, cool and fluid articles. Several medical 
authorities recommend a food made of Shashtika rice 
with milk, to be given to her specially in the third 
month of gestation, with curd in the fourth, with milk 
in the fifth and with clarified butter in the sixth 
month of pregnancy. Food largely composed of 
milk and butter, as well as relishing (Hridya) food 
with the soup of the flesh of jdngala (wild) animals 
should be given to her in the fourth, food with milk 
and clarified butter in the fifth, adequate quantity 
of clarified butter prepared with (the decoction of) 
Svadamshtra, or gruel (Yavagu) in the sixth ; and clarified 
butter prepared with (the decoction of) the Prithak- 
parnyddi group in adequate quantities in the seventh 
month of gestation. These help the foetal development. 
For the purpose of restoring the Vayu of her body 
(nervous system) to the normal course and condition and 
for the cleansing of the bowels, the enciente should be 
given an AsthApana (enema), composed of a decoc- 
tion of Vadara mixed with Vala, Ativala, Satapushpa, 
Palala (flesh), milk, cream of curd, oil, Saindhava salt, 

* "Hridya" here means the diet in which there is an abundance of 
Ojo-producing (albuminous) properties. 

2t 



2l8 THE SUSHRUTA SAMHITA. [Chap. X. 

Madana fruit, honey and clarified butter. After that 
she should have an Anuvdsana (enema) made up of 
oil prepared with milk and decoction of the drugs 
known as the Madhuradi-gana. This restores the Vdyu 
to its normal course and condition, which brings on 
an easy and natural parturition unattended with any 
puerperal disorders. Henceforth up to the time of 
delivery the enciente should have liquid food (Yavagu) 
made up of emollient substances (fatsj and soup of the 
flesh of Jangala animals (deer, etc.). If treated on these 
lines the enciente remains healthy and strong, and 
parturition becomes easy and unattended with evils. 
An enciente should be made to enter the lying-in 
chamber in the ninth month of her pregnancy and 
under the auspices of happy stars and propitious 
lunar conditions. The chamber of confinement (Sutika- 
griha) in respect of a Brdhmin, Kshatriya, Vais'ya and 
Sudra mother should be raised on grounds respectively 
possessed of white, red, yellow and black soils, and 
made of Vilva, Vata, Tinduka and Bhallataka wood. 
Couches should be made of these woods respectively 
in cases of the different social orders. The walls of 
the room should be well-plastered and the furniture 
(necessary accessories) should be placed tidy in their 
proper places. The door of a lying-in chamber should 
be made to face the south or the east, and the inner 
dimensions of the room should be eight cubits in length 
and four in breadth. Religious rites for warding off 
the visitation of evil spirits and malignant stars should 
be undertaken at (the door of) the room. 3. 

Signs of imminent parturition-(M.~- 

T.) :— A looseness of the sides of the abdomen and 
untying of the umbilical cord of the child (from the 
cardiac cord of its mother) and a perception of the 



I 



ap- ^l SARlRA STHANAM. 2tg 

characteristic pain at the waist would indicate the 
approach of the time of delivery. A constant and 
severe pain at the waist and the back, constant (in- 
voluntary) motions of the bowels and micturition and 
mucous discharge from the vulva are the symptoms 
which are manifest at the time {i.e., a little before) of 
parturition. 4-5. 

Preliminary Measures :— Rites of bene- 
diction should be performed for the safety of the 
enciente in her travail and she should be made to 
pronounce benedictory Mantras surrounded by male 
babies on all sides. A fruit with a masculine name 
should be given in her hand. Her body should be 
anointed with oil and washed with warm water and 
she should be made to drink largely a gruel (Yavagu) 
made of articles (which exert a beneficial virtue at the 
time). Then she should be laid on her back on a soft 
and sufficiently spacious bed, her head being placed 
on a pillow and her legs slightly flexed and drawn up. 
Four elderly ladies with paired finger-nails and skilled 
in the art of accouchement and with whom she feels 
no delicacy, should attend and nurse her at the time. 6. 

Then after having gently lubricated the mouth of 
the parturient canal along the natural direction of the 
pubic hairs (Anuloma) (so as not to create any discom- 
fort in the part) one of them (elderly ladies) should 
address the enciente as follows : — "O fortunate damsel, 
try to bear down the child; but do not make such an 
attempt in the absence of real pain." On experiencing 
an untying of the umbilical cord of the child, the 
enciente should gently make such urgings, whenever 
she will experience pain in the pelvic, pudendal and 
pubic regions and in the region between the neck of 
the bladder and the pelvis. Deep urgings should be 



2^C THE SUSHRUtA SAMttlTA. Chap. X.] 

made on the exit of the foetus out of the uterus, 
and after that deeper urgings should be made during 
the passage of the child through the canal until 
delivery. 7. 

An urging (made by the enciente) in the absence 
of any real pain may lead to deafness, dumbness and 
deformity of the jaw-bones of the child or subject 
it to attacks of cough, asthma, consumption, etc., or lead 
to the diseases of its head, or to the birth of a haunch- 
backed or deformed child. A case of abnormal presenta- 
tion (Pratiloma) should be converted into the normal 
or cephalic one (Anuloma) by version* 8-9. 

In the case of protracted delivery, e, g., an obstruc- 
tion of the child at the vagina, — the vagina should be 
fumigated with the fumes of the slough (cast-off skin) 
of a cobra (snake) or with the fumes of Pinditaka 
(Madana) or the roots of Hiranyapushpi (Kantakdri) 
should be tied (round the neck or the waist) or Suvar- 
chala {Atasi) or Vis'alyd (Patald) should be tied round 
the hand (wrist) and leg (ankle) of the parturient 
woman. 10. 

Post-parturient Measures :— The shreds 

or membranes lying on the body of the child should be 
removed immediately after its birth and its mouth 
should be cleansed with clarified butter and rock-salt. 
Then a linen pad soaked in clarified butterf should be 
applied on the head of the new-born baby. Then the 
umbilical cord, after having been slightly drawn out, 
should be ligatured with one end of a string at a point 
eight fingers apart from its navel, the other end 

• The various forms of (Pratiloma) abnormal presentations have been 
described under Mudha-Garbha Nidanam (Nidan-Sthana — Chap. IX.) 
and their treatment is to be found in Chikitsa-Slhana — Chap. XV. 

t Ijrahmadcva recommends Vala-Taila instead of clarified butler. 



Chap. X.] SARiRA STUANAM 2^1 

of the string being tied round its neck ; then the um- 
bilical cord should be severed immediately above the 
ligature, ii. 

Natal Rites : — Then having sprayed (the face 
ofj the baby with cold water, the post-natal rites should 
be performed unto it. After that the baby should be 
made to lick an electuary composed of honey, clarified 
butter and the expressed juice of Brdhnii leaves and 
Anantd, mixed with (half a Rati weight of) gold dust and 
given with the ring-finger of the feeder. Then the body 
of the child should be anointed with Vald-taila and 
it should be bathed in an infusion of the barks of 
Kshiri trees, or in the washings (decoctions) of drugs 
known as the Sarvagandha (ElAdi group), or in water 
in which red-hot gold or silver bar has been immersed, 
or in a tepid decoction of Kapittha leaves, according 
to the nature of the season, the preponderance of the 
deranged Doshas in its body and according to its physi- 
cal conditions. 12. 

Diet for the Child— (M.—T.) :— The milk in 
the breasts of a newly parturient woman sets in three or 
four days after parturition owing to the dilation of the 
orifices of the milk ducts (galactoferous ducts). Hence 
the baby should be fed thrice daily (morning, noon 
and evening) on a handful (child's own hand) of clarified 
butter and honey mixed with (a Rati weight ofj pul- 
verized Anantd roots sanctified with Mantras on the 
first day ; and on the second and third days the child 
should be fed on clarified butter prepared with the 
Lakshand ,root). On the following (fourth; day the child 
should be fed on its handful of honey and clarified 
butter only twice (/. ^., in the morning and at noon). 
(From the evening of fourth day) the mother should 
first squeeze off a quantity of her milk and then give 



222 THp: SUSHRUTA SAMHITA. CChap. X. 

the child her breast. (This rule should be observed 
at the time of tending the child every day). 13-14. 

Treatment of the mother:— The body 

of the mother should be anointed (after parturition) 
with the Vald-Taila and treated sboth internally and 
externally) with a decoction of Vayu-subduing drugs 
(such as the B hadra-D drv ddi gvou^, etc.). If still there be 
any abnormality in the condition of the Doshas (the 
discharge of vitiated blood / e., lochia), the mother 
should be given to drink a luke-warm solution of 
treacle mixed with powders of Pippali, Pippali roots, 
Hasti-pippali, Chitraka and S'ringavera, and the medi- 
cine should be continued for two or three days or 
longer, (if necessary), till the disappearance of the 
vitiated blood (lochia). When the discharge gets normal 
(i e., on the appearance of healthy lochia), the mother 
should be made to take for three days a gruel 
(Yavdgu) prepared with the decoction of the drugs 
constituting the Viddri-Gandhddi Gana and mixed with 
(a good quantity of; clarified butter or a Yavagu prepared 
in milk. After that a meal of boiled Sali-rice and a 
broth made from the meats of Jangala animals 
boiled with barley, Kola and Ktdattha pulse, should be 
prescribed for her, taking into consideration the 
strength and the condition of her appetite (Agni or 
digesting power). The mother should observe this 
regimen of diet and conduct for one month and a half 
(after delivery). After this period she may be at 
liberty to choose any food to her liking and revert 
to her natural mode of living. According to several 
authorities, however, a woman does not regain her 
natural temperament of body till the reappearance of 
the healthy menstruation (after parturition). 15. 

A strong but newly delivered woman, born and 



Chap. X.] SARIRA STIIANAM. 223 

bred up in a Jdngala country should be given to drink, 
for three or five nights, either oil or clarified butter 
in an adequate quantity with an after-potion consisting 
of the decoction of drugs constituting the group known 
as the Pippalyddi Gana. She should be daily anointed 
with oil, etc. If, however, of delicate health, she 
should be made to take, for three or five nights in 
succession, a medicated Yavagu (gruel) as described in 
the last para. Thenceforth a diet of demulcent pro- 
perties should be prescribed for her and her body 
should be regularly washed with a copious quantity 
of tepid water. A mother, after parturition, should 
forego (for a considerable time) sexual intercourse, 
physical labour and indulgence in irascible emotions/ 
etc. 1 6 

lYIemorable Verses :— Any disease acquired 
by a newly delivered mother (Sutika) by her injudicious 
conduct of life soon lapses into one of a difficult type 
(hard to cure) ; and it becomes incurable if it be due to 
too much fasting. Hence a wise physician should treat 
her with such measures as are natural and congenial to 
her temperament, the time, the place and the nature 
of the disease, so that she may not be afflicted with any 
evil effect. 17. 

A placenta retained in the uterus causes constipa- 
tion (Anaha) of the bowels and distention of the 
abdomen (^tympanitesX Hence in such a case her 
throat should be tickled with a finger covered with 
hair ; or the exterior orifice of the vagina should be 
fumigated with the fumes of the cast-off'skin of a snake, 
Katuka, Aldvu, Kritavedhana and mustard seeds mixed 
with mustard oil. In the alternative, a plaster of Ldngali 

* Fifteen kinds of emotions as described in the thirty-ninth chapter of 
ihe Chikitsa-sthanap,!, 



224 THE SUSHRUTA SAMIIITA. [Chap. X. 

roots should be applied to the palms and soles of her 
hands and feet ; or the milky juice of Snuhi tree 
should be applied over her scalp ; or a compound made 
of pasted Ldngali roots and Kushtha mixed with either 
wine or the cow's urine should be given her for drink. 
A Kalka either of S'dli roots or of the drugs con- 
stituting the Pippalyddi Gana mixed with wine (Sura) 
should be given her for the purpose In the alterna- 
tive, an Asthapana (enema) of white mustard seeds 
Kushtha (Kuda), Ldngali, and the milky juice of Mahd- 
vriksJia, mixed with Sura-manda should be prescribed. 
(If the above measures fail) an Uttara-Vasti (uterine 
douche) prepared with the aforesaid drugs and boiled in 
mustard oil should be applied ; or else the placenta 
should be removed by the hand lubricated with an olea- 
ginous substance and with the nails clipped off. i8. 

IVIakkalla and its Treatment :— The 

lochia of a newly delivered woman whose organism 
has become excessively dry on account of profuse use 
of absorbants or deranged by any other causes, — the 
lochia being obstructed in its exit by the local Vayu, — 
gives rise to Granthis (nodules) which may appear 
below the navel, on the sides of the pelvis about the 
region of the bladder or of the pubis. Severe piercing 
pain (Sula) is felt about the region of the navel, the 
stomach and the bladder and a sensation of pricking 
with needle and cutting pain in the intestines. 
At the same time the abdomen becomes distended 
with the retention of urine. These are the symptoms 
of Makkalla. In such a case, a decoction of the drugs 
of the Viratar-vddi 6^<^;/^ mixed with a powdered com- 
pound of the Ushakddt Gana should be given her. In the 
alternative, a potion of carbonate of potash [Yavakshdra) 
dissolved in tepid water or in clarified butter ; of rock- 



Chap. X.] SARIRA STHANAM. 225 

salt dissolved in the decoction'of the Pippalyddi Gana ; 
of a compound made of the powdered drugs of the latter 
Gana with Surd-manda ; of the powders of cardamom 
and PancJici-kolas dissolved in the decoction of the 
drugs of the Vaninddi Gana ; of the powders of pepper 
and Bhadraddrii dissolved in the decoction of the 
Prithakparnyddi Gana ; or of pulverized Trikatu^ 
Chaturjdtaka and Knstiimhuru mixed with old treacle ; 
or of simple Arishta, should be prescribed. 19. 

Management of the Child:— The baby 

being wrapped up in silk should be laid on a bed covered 
with a silken sheet ; it should be fanned with the 
branches of a Pilu, Nimba, Vadari, or Parushaka tree. 
A (thin^i pad (Pichu) soaked in oil should be constantly 
kept on the head of the child, and its body should be 
fumigated with the fumes of drugs (^,^., Vac ha, mustard, 
etc.) potent enough to keep off the (evil) influences of 
demons and evil spirits. The same drugs should be tied 
round the neck, hands, legs and head of the infant and 
the floor of the lying-in room should be kept strewn 
over with pounded sesamum, mustard, linseed [Atasi). A 
fire should also be kept kindled in the chamber. Measures 
laid down in the chapter on the nursing of an Ulcer- 
patient (chapter IX. Sutra.) should be observed in the 
present case as well. 20. 

Then on the tenth day of its birth the parents having 
performed the necessary rites of benediction and cele- 
brated the occasion with suitable festivities, shall give 
the child a name of their own choice or one determined 
by its natal a^trism, etc. 21. 

Lactation and selection of a wet- 
nurse : -For the healthy gro vth of the child a wet- 
nurse should be selected from among the matrons of 
its own caste (Varna\ and possessed of the following 

29 



226 THE SUSHRUTA SAMHITA. [Chap. X. 

necessary qualifications. She should be of middle 
stature, neither too old nor too young (middle-aged), 
of sound health, of good character (not irascible or easily 
excitable), not fickle, ungreedy, neither too thin nor too 
corpulent, with lips unprotruded, and with healthy and 
pure milk in her breasts which should neither be too 
much pendulent nor drawn up. It should be carefully 
observed that her skin is healthy and unmarked by any 
moles or stains, she being free from any sort of crime 
(such as gambling, day-sleep, debauchery, etc.). She 
should be of an affectionate heart, and with all her 
children living. 

She should be of respectable parentage and conse- 
quently possessed of many good qualities, with an exu- 
berance of milk in her breasts, and not in the habit of 
doing anything that degrades woman in life. A "Syama ' 
girl possessed of the aforesaid qualities makes a good 
wet-nurse. A child nursed at the breast of a woman 
with upturned or unprominent nipples is apt to be 
deformed (Karala) in features, while extremely pendu- 
lous (large and flabby) breasts may suffocate the child 
by covering its mouth and nostrils. Having chosen a 
wet-nurse of the commendable type, the child with its 
head well-washed should, on an auspicious day, be laid 
on her lap wrapped in a clean and untorn linen. The 
face of the child should be turned towards the north, 
while the nurse should look to the east at the time. 
Then, after first having a small quantity of the milk 
pressed out and the breast washed and consecrated with 
the following Mantras (incantations) the child should be 
made to suck her right breast. 22. 

Metrical Texts :— ''O, thou beautiful damsel, 
may the four oceans of the earth contribute to the 
secretion of mjlk in thy breasts for the purpose of in^-: 



Chap. X,] SARtRA STHAKAM. 227 

proving the bodily strength of the child. O, thou with 
a beautiful face, may the child, reared on your milk, 
attain a long life, like the gods made immortal with 
drinks of ambrosia". 22. 

A child nursed at the breast of any and every 
woman for want of a nurse of the commendable type, 
may fall an easy prey to disease, owing to the fact of the 
promiscuous nature of the milk proving incongenial to 
its physical temperament. The milk of a nurse not 
being pressed out and spelled off at the outset may 
produce cough, difficulty of breathing, or vomiting of 
the child, owing to the sudden rush of the accumulated 
milk into its throat choking up the channels. Hence 
a child should not be allowed to suck in such milk. 23. 

The loss or suppression of the milk in the breasts of 
a woman is usually due to anger, grief, and the absence 
of natural affection for her child, etc. For the purpose of 
establishing a flow in her breast, her equanimity should 
be first restored, and diets consisting of Sdli-rice, barley, 
wheat, Shashtika, meat-soup, wine (Surd\ Souviraka, 
sesamum-paste, garlic, fish, Kas'eruka, S'ringdtaka, lotus- 
stalk, Viddri-kandi, Madhuka flower, S'atdzari, Nalikd^ 
Aldvu, and Kdla-S'dka, etc.. should be prescribed. 24. 

Examination, etc., of milk :— The breast- 
milk of a nurse or a mother should be tested by casting 
it in water. The milk which is thin, cold, clear, and 
tinged like the hue of a conch-shell, is found to be 
easily miscible with water, does not give rise to 
froths and shreds, and neither floats nor sinks in water, 
should be regarded as pure and healthy. A child fed 
on such milk is sure to thrive and gain in strentgh and 
health. A child should not be allowed to take the 
breast of a hungry, aggrieved, fatigued, too thin, too 
corpulent, fevered, or a pregnant woman, nor of one in 



■22S THE SUSHRUTA SAMHITA . [Chap. X. 

whom the assimilated food is followed by an acid reac- 
tion, or of one who is fond of incongenial and unhealthy 
dietary, or whose fundamental principles are vitiated. 
A child should not be given the breast until an adminis- 
tered medicine is assimilated in its organism, lest this 
should give rise to a violent aggravation of the pharmaco- 
logical action of the medicine, as well as of the deranged 
Doshas (Vdyu, Pitta, etc.), and the refuse matters (Malas) 
of its body. 25. 

IVIemorable Verses:— The Doshas (Vayu, 

Pitta and Kapha) of a wet-nurse are aggravated by 
ingestion of indigestible or incompatible food, or of those 
articles which tend to derange the Doshas of the body, 
and hence her milk may be vitiated. A child, fed on the 
vitiated milk of a woman, vitiated by the deranged 
Doshas owing to injudicious and intemperate eating 
and living, falls an easy prey to physical disease, An 
intelligent physician in such a case should devise means 
for the purification of the milk as well as of the derang- 
ed Doshas which account for such vitiation (inasmuch as 
the medication of the child alone will not produce any 
satisfactory effect). 26-27. 

Infantile diseases and their Diagno- 
sis : — -A child constantly touches its diseased part or 
organ and cries for the least touch (by another of that 
part of its body). If the seat of disease be its head, the 
child cannot raise nor move that organ and remains with 
its eyes closely shut. A disease seated in its bladder 
gives rise to retention of urine, thirst, pain and occa- 
sional fainting fits. A retention of urine and stool, 
discolouring of complexion, vomiting, distention of the 
abdomen, and gurgling in the intestines indicate the 
seat of the disease to be its Koshtha (colon). A 
constant crying (and the child's refusal to be consoled) 



Chap. X.] SARIRA STHANAM. 229 

would signify that the diseased principle (morbiferous 
diathesis) extends all through its organism. 28. 

Treatment of Infants :— Medicines laid 
down under the head of a particular disease should like- 
wise be prescribed in the case of its appearance in a 
child or an infant ; but then only the remedies of mild 
potency and those which do not tend to disintegrate the 
bodily fat and Kapha should be given in adequate 
doses (according to age, etc.) as mentioned here- 
after and administered through the vehicle of milk and 
clarified butter, to a child living on milk alone, while the 
nurse also is to take the same medicines as well * In 
the case of a child fed both on milk and (boiled) rice 
{KshirdnnddaX .Q., living on both solid an d liquid food) the 
medicine should be administered both to the child and 
its wet-nurse. In the case of a child living on solid food 
only, decoctions (Kashdya) etc. should be given to the 
child and not to the nurse. Medicines to the quantity of 
a small pinchful may be prescribed for a suckling who 
has completed its first month of life. Kalkas (medicated 
pastes) should be given to a child fed on both milk and 
rice to the size of a stone of a plum-fruit (Kola), and the 
dose for a child fed on rice (solid food) only being to 
the size of a plum (Kola).t 29. 

* Milk and clarified butter being congenial to the constitution of 
infants should be used as vehicles for drugs in their cases but, these are 
not necessary in the case of the nurse. 

t According to several other authorities, the dosage in the case of 
children is to be regulated as follows : — 

In the case of a child, one month old, drugs should be given in the form 
of an electuary through the vehicle of milk, honey, syrup, clarified butter, 
etc,— the dose being one Rati (about two grains) at first, and gradually 
increased by a Rati a month, till it completes one year. After this time the 
dose is to be one Masha (about twenty grains) for each year of age till 
he is fifteen. 

This dosage, however, does not apply in the present age.— Ed. 



230 THE SUSHRUtA SAMHITA. tChap. X. 

Metrical Texts :— in the case of any disease 
of a child nursed at the breast, the breasts of the nurse 
should be plastered with the pastes of drugs recommended 
by physicians for the particular malady (instead of 
giving the drugs to the child), and the child made to 
suck the same. The use of clarified butter is not bene- 
ficial to a child on the first day of an attack of Vata- 
jvara (fever due to the derangement of the bodily Vayu), 
within the first two days of an attack of Pittaja fever, 
and within the first three days of that of Kaphaja fever. 
But the use of clarified butter may be prescribed for 
an infant fed on milk and boiled rice, or on boiled rice 
alone, according to requirements. 30-3 f. 

In case of fever a child should be given no suck at 
all, lest the symptoms of thirst might develop. Pur- 
gatives, Vastis, or emetics are forbidden in the disease 
of children, unless the disease threatens to take a fatal 
course. 32. 

If the local Vayu aggravated by the waste of brain- 
materials (Mastulunga), bends down the palate bone of a 
child attended with an excessive thirst and agony, 
clarified butter boiled with (the decoction and Kalka of) 
the drugs of the Madhura Gana, should be used both 
internally and externally, and the patient should as well 
be treated with spray of cold water (to stimulate him). 
The disease in which the navel of a child becomes 
swollen and painful, is called Tundi. It should be 
remedied by applying fomentations, medicated oils, 
Upanahas, etc., possessed of the virtue of subduing the 
Vayu. A suppuration of the anal region (Guda-pSika) of 
a child should be treated with Pittaghna (Pitta-destroy- 
ing) measures and medicines. Rasanjana used inter- 
nally and externally (as an unguent) proves very efifica- 
cious in these cases. 33-35. 



Chap. X.'] SARIRA STHANAM. 23I 

Infantile Elixirs :— Clarified butter cooked 
with (the decoction and Kalka of) white mustard seeds, 
Vachd, Mdnsi, Payasyd, Apdmdrga, S'atdvari, Sdrivd, 
Brdhmi, Pippali^ Hai^idrd^ K^ishtJLa and Samdhava salt 
should be given to an infant fed exclusively on milk. 
Clarified butter prepared with (the docoction and Kalka 
of) Madhika (Yashtimadhu), Vacha, Chitraka, Pippali 
and Triphald should be given to an infant fed both on 
milk and (boiled) rice (solid and liquid food). Clarified 
butter boiled with (the decoction and Kalka ofj Das'amula, 
milk, Tagara, Bhadraddru, MaricJia, honey, Vidanga, 
Drdkshd and the two sorts of Brdhmis should be given 
to an infant fed on (boiled) rice (solid food) By these the 
health, strength, intellect and longivity of the child 
is improved. 36-37. 

A child should be so handled or lifted as not to 
cause any discomfort. A baby should not be scolded, 
nor suddenly roused up (from sleep), lest it might get 
awfully frightened. It should not be suddenly drawn 
up nor suddenly laid down, lest this should result in the 
derangement of its bodily Vdyu. An attempt to seat 
it (before it has learnt to sit steadily), may lead to 
haunch-back (Kyphosis). Lovingly should a child 
be fondled and amused with toys and play-things. 
A child unruffled by any of the above ways becomes 
healthy, cheerful and intelligent as it grows older. An 
infant should be guarded against any exposure to the 
rains, the sun, or the glare of lightning. He should not 
be placed uuder a tree or a creeper, in low lands, 
and in lonely houses or in their shades (caves) ; and it 
should be protected from the malignant influences of 
evil stars and occult powers. 38. 

IVIctrical Texts :— A child should not be left 
(alone) in an unclean and unholy place, nor under the sky 



232 THE SUSHRUTA SAMHITA. [Chap. X. 

(uncovered place), nor over an undulating ground, nor 
should it be exposed to heat, storm, rain, dust, smoke and 
water. Milk is congenial to the organism of a chiid, 
i e., it is its proper food Hence in the absence of 
sufficient breast-milk, the child should be given the milk 
of a cow or of a she-goat in adequate quantities. 39. 

In the sixth month of its birth the child should be 
fed on light and wholesome boiled rice. A child should 
always be kept in an inner apartment of the house, 
and religious rites should be performed on its behalf for 
the propitiation of evil deities, and it should be carefully 
guarded against the influences of evil stars. 40. 

Symptoms when a malignant star, 

etc., strikes :— The child looks frightened and 
agitated, cries, becomes unconscious at times, wounds 
himself or its nurse with its teeth and finger-nails, 
gnashes its teeth, crooks, yawns, or moves its eye-brows 
with upturned eyes, vomits frothy matter, bites its lips, 
becomes cross, passes loose stool mixed with shreds 
of mucus, cries in an agonised voice, becomes dull in 
complexion, becomes weak, does not sleep in the night, 
does not suck the breast as before, or emits a fishy, 
bug-like or mole-like smell from its body — these are 
the general symptoms exhibited by a child under the 
influence of a malignant star or planet which will be 
specifically described later on in the Uttara-Tantra 41. 

Education and IVIarriage : -The educa- 
tion of a child should be commenced at a suitable age 
and with subjects proper to the particular social Varna 
or order it belongs to. On attaining the twenty-fifth year 
he should marry a girl of twelve. A conformity to 
these rules, is sure to crown him with health, satisfaction, 
progeny and a capacity for fully discharging the religious 
rites and paying off his parental debts. 42.. 



Chap. X.J SARiRA StHANAM. 2^$ 

IVIetrical Texts :— An offspring of a girl below 
the age of sixteen by a man below twentpjr-five is 
usually found to die in the womb. Such a child, in the 
event of its being born alive, dies a premature death 
or else becomes weak in organs (I ndriyas). Hence agirl 
of extremely tender age should not be fecundated at all. 
An extremely old woman, or one suffering from a 
chronic affection (of the generative organ), or afflicted 
with any other disease, should not be likewise impreg- 
nated. A man with similar disabilities should be held 
likewise unfit. 40-44. 

A foetus, on the point of being miscarried on account 
of the above-mentioned causes, produces pain in the 
uterus, bladder, waist (Kati), and the inguinal regions 
(Vamkshana) and bleeding. In such a case, the patient 
should be treated with cold baths, sprays of cold water 
and medicated plaster (Pradeha) &c., at the time, and 
milk * boiled with drugs constituting the Jivaniya 
group, should be given to her for drink. In case of 
unusual movements of the foetus in the womb, the 
enciente should be given a drink of milk boiled with the 
drugs of Utpalddi Gana^^QX soothing and making It 
steady in its place. 45. 

A foetus being displaced from its normal position 
produces the following symptoms, viz , pain or spasms 
in the back and the sides (Pars'va), burning sensation, 
excessive discharge of blood and retention of urine and 
fceces A foetus changing place or shifting from one 
place to another, swells up the abdomen (Koshtha). 
Cooling and soothing measures should be adopted in 
such cases. 46. 

* Jivaniya drugs two Tolas, milk sixteen Tolas and water sixty-four 
Tolas, to be boiled and reduced to sixteen Tolas, ?'.(?., to wtight of the 
milk, 

30 



234 THE SUSHRUTA SAMHITA. [Chap. X. 

Medical Treatment :— in a case of pain 

under the circumstances, the enciente should be made 
to drink a potion consisting of milk boiled with Mahd- 
sdha, Kshudrasahdf Madhuka flower, S'vadanstrd and 
Kantakdri, mixed with sugar and honey. In the case of 
retention of urine, the patient should be made to 
drink a potion of milk boiled with drugs known as the 
Ddrvddi Gana (mixed with sugar and honey). In the 
case of A'naha (retention of stool attended with disten- 
tion of the abdomen), a potion consisting of milk 
boiled with asafetida, Sauvarchala salt, garlic and Vacha 
(mixed with honey and sugar) should be given. In 
cases of excessive bleeding, linctus made of the powdered 
chamber of a Koshthdgarika insect * , Samangd^ 
Dhdtaki flowers, Navamdlikd, Gairika, resin and Rasdn- 
fana, or of as many of them as would be available, 
mixed with honey, should be licked. In the alternative, 
the bark and sprouts of the drugs known as the Nya- 
grodhddi Gana mixed with boiled milk should be 
administered, or a Kalka of the drugs of the Utpaladi 
group mixed with boiled milk should be used, or a 
Kalka of S'aluka, S'ringataka and Kas'eru mixed with 
boiled milk should be given. As a further alternative, the 
enciente may be made to eat cakes made of powdered 
Sali rice with the decoction of Udumbara fruit and 
Audaka-kanda, mixed with honey and sugar. A piece 
of linen or a plug soaked in the expressed juice of the 
drugs of the Nyagrodhadi group should be inserted 
into the passage of the vagina. 47. 

In a case of pain unattended with bleeding, the 
enciente should be made to drink a potion composed of 
milk-boiled with J/<^<//////^^(Yashtimadhu), Devaddm and 

* There is a kind of insect which makes its chamber with earth 
generally under the ceiling or on the walls. This earth should be used. 



Chap. X.] SARIRA STHANAM. 235 

Payasyd ; or with As'mantaka^ Satdvari and Payasyd ; 
or with the drugs of the group of V iddrigandhddi Gana ; 
or with Vrihati, Kantakdri, Utpala, S'atdvari, Sdrivdy 
Payasyd and Madhuka (Yashtimadhu). These remedies 
speedily applied tend to alleviate the pain and make the 
foetus steady in the womb. 48. 

After the foetus has been steadied by the aforesaid 
mesaures, a diet consisting of (boiled rice and) cow's 
milk, boiled with the dried tender fruits of Udmnvara, 
should be prescribed for the patient. In the event of 
miscarriage, the patient should be made to drink a 
Yavigu (gruel) of the Udddlaka rice, &c., cooked with 
the decoction of the Pachaniya group (Pippalyddi) and 
devoid of all saline and fatty matter, for a number of 
days corresponding to that of the month of gestation. 
Old treacle mixed with the powdered drugs of the 
Dipaniya group (Pancha-kola), or simply some Arishta 
(Abhay^rishta, etc.), should be given, in the event 
of there being pain in the pelvis, bladder and 
abdomen. 49. 

The internal ducts and channels (Srotas) stuffed with 
aggravated Vdyu lead to the weakening (Laya) of the 
foetus and, if the state continues, it leads even to its 
death. Hence the case should be treated with mild 
anointing measures, etc., (Sneha-karma, etc.,) and gruels 
made of the flesh of the birds of the Utkros'a species and 
mixed with a sufficient quantity of clarified butter, should 
be given to her. As an alternative, Kulmasha * boiled 
with .Masha, sesamum and pieces of dried (tender) 
Vilva fruit should be given her, after which she should 
be made to drink, for a week, honey and Mdddhvika (a 
kind of weak wine). At the non-delivery of the child 

* **Kulmdsha" may mean either Kulattha pulse or half boiled wheat, 
barley, etc. 



236 THE SUSHRUTA SAMHITA. [Chap. X. 

•even after the lapse of the full term of gestation, the 
eaciente should be made to thrash corn with a pestle in 
9,;n Udukhala or mortar (husking apparatus) or should he 
il9,de -to sit or move (on legs or by conveyance), on an 
juneven ground. 50. 

Atrophy of a foetus in the womb should be ascribed 
to the action of the deranged Vdyu. This is detected 
by the comparatively lesser fulness of the abdomen 
of the enciente and slow movement of the foetus in 
tiie womb. In such a case, the enciente should be 
treated with milk, with Jhe Vrimhaniya (of restorative 
a.^d construQtive properties) drugs, and with meat- 
soup.* 51. 

A combination of ovum and semen affected by the 
deranged Vayu in the womb, may not give rise to a 
SjUccessful fecundation (living impregnated matter), but 
leads to a distention of the abdomen (as in pregnancy), 
which again, at any time, may disappear of itself. And 
this is ascribed by the ignorant to the malignant 
influence of Naigamesha (spirits). Such an impregnated 
matter, sometimes lying concealed in the uterus, is 
called Nagodara, which should be treated with the 
remedies laid down under the head of Lina-Garbha 
(weak foetus). 52. 

Now we shall discourse on the management of 
pregnancy according to the months (period) of gestation. 
Metrical Texts:— The following receipes, such as, 
(i) Madhuka (Yashtimadhu), S'dkavija, Payasyi, and 
Devadiru ; (2) As'mantaka, black sesamum, pippali, 
Manjishth^, Tcimra-valli and Satcivari ; (3) Vrikshddani, 
Payasya, Latd. (Durvi), Utpala and Sdriv^ ; (4) Ananta, 
Siriya, RdsnA, Padma, and Madhuka (Yashtimadhu) ; 

* The panicle "chA" in the text signifies the use of any other 
consiructive tonic. 



Chap. X.] SARIRA STHANAM. 237 

(5) Vrihati, Kantakdri, Kas'mari, sprouts (Sunga) and 
barks of milk-exuding trees (as, Vata, etc.), and clariiied 
butteri* ; (6) Pris'ni-parni, Vald, Sigru, S'vadanshtra 
and Madhuparnika ; and (7) S'ring'taka, Visa (stalks 
of lotus), Draksha, Kasaru, Madhuka (Yashtimadhu), 
and sugar ; should successively be given with milk* to 
an enciente, from the first to the seventh month of her 
gestation, in the case of a threatened miscarraige or 
abortion. 53. 

An enciente should be made to drink milk boiled 
with the roots of Kapittha, Vrihati, Vilva, Patola, 
Ikshu and Kantakari, (in case of impending or 
threatened miscarraige) in the eighth month of her 
pregnancy. In the ninth month (and under similai* 
conditions), the potion should be made up of Madhuka 
(Yashtimadhu), Ananta-mula, Payasha and Sariva. In 
the tenth month (and under similar conditions), a potion 
consisting of milk boiled with Sunthi and Payasyd 
is beneficial, or, in the alternative, may be given a potion 
made up of milk with Sunthi, Madhuka (Liquorice, and 
Devadaru. The severe pain would vanish and the 
fcetus would continue to develop safely in the womb, 
under the aforesaid mode of treatment. 54-57' 

A child born of a woman, who had remained sterile 
(not-conceived) for a period of six years (Niviitta- 
prasava)* after a previous child-birth, becomes a short- 
lived one. 58. 

* ChakradaUa reads "Visam" (stalks of lotus) instead of "Ghritara" 
(clarified butter). 

t If a conception does not occur in a woman for a period of more than 
five years a''ter a child-birth, she is called Nivritta-prasaVSl. 

* Sivadasa also says that powders of these drugs should be given 
with boiled milk, but he adds that some authorities recommend theaQ 
drugs to be boiled in milk according to Kshira-paka-vidhi. 



238 THE SUSHRUTA SAMHITA. [Chap. X. 

Application of mild emetic medicines, (though for- 
bidden in the case of a pregnant woman), may be 
resorted to, in the case of a fatal disease, (even in that 
stage). A diet consisting of sweet and acid things should 
be prescribed for her, so as to bring the deranged 
Doshas to the normal state ; mild Sams'amaniya 
(soothing and pacifying) medicines should be applied 
and food and drink consisting of articles mild in their 
potency, predominently sweet-tasting and not injurious 
to the foetus, should be advised and mild (external) 
measures not baneful to the foetus should be resorted 
to, according to the requirements of the case. 59. 

IVIemorable Verses :— The growth, memory, 

strength and intellect of a child are improved by the 
use of the four following medicinal compounds, used as 
linctus (Prds'a), viz., (i) well-powdered gold, Kushtha, 
honey, clarified butter and Vacha ; (2) Matsyakshaka* 
(Brdhmi), Sankha-puspi, powdered gold, clarified butter 
and honey ; (3) Arkapuspi, honey, clarified butter 
powdered gold and Vacha ; and (4) powdered gold, 
Kaitaryyah (Maha-Nimba), white Durba,t clarified 
butter and honey. 60. 

Thus ends the tenth Chapter of the S'arira Sthanam in the Sus'rula 
Samhita, which treats of the nursing and management etc. of pregnant 
women. 

* Some, however, explain Matsyakshaka to be Dkuslura; others again 
say it is a kind of red-flowered shrub grown in the Anupa country. 

t The word "S'veta," in the Text, may either be adjective to 
"DurvgC" and mean "white" or it may mean white Vacha or white 
Aparajita or white Durv£t. 



Here ends the ^arira Sthanam. 



THE 

SUSRUTA SAMHITA 

CHIKITSA-STHANAM. 

(Section of Therapeutics). 



CHAPTER I. 

Now we shall discourse on the medical treatment 
of the two kinds of inflamed ulcers (Dvivraniya 

Chikitsitam). i. 

Ulcers may be grouped under two heads according 
as they are Idiopathic or Traumatic in their oiigin. 
The first group includes within its boundary all ulcers 
that are caused through the vitiated condition of the 
blood or the several deranged conditions of the Vayu, 
Pitta and Kapha, or are due to their concerted 
action (Sannipata), while the second group embraces 
those which are caused by the bites of men, beasts, 
birds, ferocious animals, reptiles or lizards, or by a 
fall, pressure and blow, or by fire, alkali, poison, or 
irritant drugs, or through injuries inflicted by pointed 
wood, skeletal bones* horns, discus, arrows, axes, 
tridents, or Kuntas (a kind of shovel\ or such other 
weapons. Although both th3se classes of ulcers possess 
many features in common, they have been grouped 
under two distinct heads on account of the diversity of 
their origin, the difference in remedial measures to be 
adopted in their treatment, and the variation in their 

* Fragments of broken pottery.^ — Dallana. 



240 THE SUSHRUTA SAMHITA. [Chap. I, 

Strength and tenacity. Hence the chapter is called 
Dvivraniya. 2. 

In all cases of traumatic ulcers, cooling measures 
should be at once resorted to, just after (the fall or 
blow or stroke), for the cooling of the expanding (radia- 
ting) heat of the incidenta' ulcer, in the manner laid 
down in respect of (the pacification of enraged) Pitta, 
and a compound of honey and clarified butter should be 
applied on the wounded locality for the adhesion 
(Sandhdna) of the lacerated parts, [and for the pacifica- 
tion, i.e, restoration to normal state, of the local blood 
and Vdyu aggravated through an obstruction of their 
passage]. Hence arises the necessity of making the 
two-fold classification of ulcers. After that (a week) 
a traumatic ulcer should be treated as an idiopathic 
one (to all intents and purposes\ inasmuch as it is 
found to be associated with deranged Vayu, Pitta or 
Kapha Hence at that stage the medical treatment 
of both the forms of ulcer is (practically) the same. 3. 

In short, ulcers are further subdivided (particularly) 
into fifteen groups, according to the presence of the 
morbific diathesis (deranged Vayu, Pitta Kapha 
and blood therein), either severally or in combi- 
nations as described (before) in the Chapter on Vrana- 
Prasna (Sutra Sthanam. Ch. XXI). Several author- 
ities, by adding the simple uncomplicated ulcers (un- 
associated with any of the morbific principles of the 
deranged Vayu, Pitta, &c.) to the list, hold the number 
of types to be sixteen. (Practically they are in- 
numerable, according to the combinations made of the 
deranged Vdyu, etc. and the different Dhaitus of the 
system). 4. 

Symptoms of ulcer may be divided into two kinds viz.^ 
General and Specific. Pain is the general characteristic 



Chap. I.] CHIKITSA STHANAM. 24t 

(of all forms of ulcer), while the symptoms, which are 
exhibited in each case according to the virtue of the 
deranged Vdyu, Pitta, etc, involved therein, are called the 
Specific ones. A Vrana is so named from its etymology 
(the term being derived from the root Vrana — to break) 
and signifies a cracked or broken condition ^of the skin 
and flesh of the afflicted part) of the body. 5. 

The Vataja- Ulcer :— The ulcer assumes a 
brown or vermilion colour and exudes a thin, slimy 
and cold secretion, largely attended with tension, 
throbbing and a sort of pricking and piercing pain (in 
its inside), which seems as if being expanded and 
extended. This type of ulcer does not extend much 
and is characterised by a complete destruction of the 
tissue (flesh). The Pittaja ulcer is rapid in its growth. 
It assumes a bluish yellow colour, exudes a hot secretion 
resembling the washings of Kims'uka flowers, and is 
attended with burning, suppuration and redness, being 
surrounded with eruptions of small yellow-coloured 
pustules. The Kaphaja ulcer is found to be extended 
and raised around its margin and is accompanied by an 
irresistible itching sensation. It is thick and compact 
(in its depth), covered with a large number of vessels 
and membranous tissues (Sira-sndyu-jala), grey in 
colour, slightly painful, hard and heavy, and exudes a 
thick, cold, white and slimy secretion. The Raktaja 
ulcer (resulting from a vitiated condition of the blood) 
looks like a lump of red coral. It is often found 
to be surrounded by black vesicles and pustules and 
to smell like a strong alkali. It becomes painful and 
produces a sensation, as if fumes were escaping out 
(of it). Bleeding (is present) and the specific symp- 
toms of the Pittaja type are likewise found to 
supervene. 6 — 9. 

31 



242 THE SUSHRUTA SAMHITA. Chap. I.] 

The Vata-Pittaja Type :— An ulcer due to 

the concerted action of the deranged Vayu and Pitta 
is marked by a pricking and burning pain and a red 
or vermilion colour. A sensation of fumes arising out 
of it (is also felt) and the ulcer exudes a secretion 
which partakes of the characteristic colours of both the 
deranged Vdyu and Pitta. An itching and piercing 
pain is felt In the ulcer due to the combined action of 
the deranged Vayu and Kapha (Kapha- Vattaja type), 
which becomes heavy and indurated, constantly dis- 
charging a cold, slimy secretion. An ulcer resulting 
from the deranged condition of the Pitta and Kapha 
(Kapha-Pittaja type) becomes heavy, hot and yellow. 
It is marked by a burning sensatian and exudes a pale, 
yellow-coloured secretion. An ulcer marked by the 
aggravated condition of the deranged Vayu and blood 
(VsLta-Raktaja type) is dry and thin and is largely 
attended with a piercing pain and anaesthesia. It 
exudes blood or a vermil-coloured secretion and is 
marked by the combined hues respectively peculiar to 
the deranged Vayu and blood. An ulcer due to the 
combined action of the deranged Pitta and blood 
(Kakta-Pittaja type) is marked by a colour which 
resembles the surface cream of clarified butter. It 
smells like the washing of fish, is soft, spreading (erysi- 
pelatous), and secretes a hot blackish matter. An 
ulcer due to the combined action of the deranged 
Kapha and blood (Kapha-Raktaja type) is red-coloured, 
heavy, slimy, glossy and indurated. It is usually 
marked by itching and exudes a yellowish bloody 
secretion. An ulcer due to the concerted action of the 
deranged Vdyu, Pitta and blood (Va'ta-Pitta-Raktaja 
type) is maiked by a sort of throbbing, pricking and 
burning pain. It discharges a flow of thin yellowish 



Chap. I.j CHIKItSA STHANAM. 243 

blood and produces a sensation, as if fumes were 
escaping (out of its cavity). An ulcer due to the con- 
certed action of the deranged Vayu, Kapha and blood 
(Vaita-Sleshma-Raktaja type) is usually attended with 
itching, throbbing and tingling sensations and thick, grey, 
blood-streaked discharge. An ulcer associated with 
the deranged Kapha, Pitta, and blood (Kapha-Pitta- 
Raktaja type) is largely attended with redness, itching, 
suppuration and burning sensation. It emits a thick, 
greyish, bloody secretion. An ulcer marked by the 
concerted action of the deranged Vayu, Pitta and 
Kapha (Satanipaitika) is attended with diverse kinds 
of pain, secretion, colour, &c., peculiar to each of 
these types. An ulcer associated with the combined 
action of the deranged Vayu, Pitta, Kapha and blood 
(Va^ta-Pitta-Kapha-Raktaja type) is attended with a 
sensation, as if it were being burnt and lacerated. It is 
largely accompanied by throbbing, itchin^^ sensation, 
a sort of pricking and burning pain, with complete 
anaesthesia in the locality; redness, suppuration, various 
other kinds of colour, pain and secretion are its further 
characteristics. 10 — 20. 

An ulcer (Vrana) which is of the same colour with the 
back of the tongue, soft, glossy, smooth, painless, well- 
shaped and marked by the absence of any kind of 
secretion whatsoever, is called a clean ulcer (Suddha- 
Vrana). 21. 

Therapeutics :— The medical (and surgical) 
treatment of a Vrana (ulcer) admits of being divided 
into sixty * different factors, such as,— Apatarpana 
(fasting or low diet), Alepa (plastering), Parisheka 
(irrigating or spraying), Abhyanga (anointing), Sveda 

* N.B. Authorities, however, differ in enumerating these factors, 
although every oiae of them sticks to the total number of sixty. 



^44 THfe SUSHRUTA SAMhITA. fChap. t. 

(fomentations, etc.), Vimldpana (resolution by mass- 
age or rubbing), Upanaha (poultice), Pdchana (inducing 
suppuration), Visrdvana (evacuating or draining), Sneha 
(internal use of medicated oils, ghrita, etc.), Vamana 
(emetics), Virechana (purgatives), Chhedana (excision), 
Bhedana (opening — e.g., of an abscess), Dirana (bursting 
by medicinal applications), Lekhana (scraping), Aharana 
(extraction^ Eshana (probing), Vyadhana (puncturing— 
opening a vein), Vidrdvana (inducing discharge), Sivana 
(suturing), Sandhana (helping re-union or adhesion), 
Pidana (pressing), Sonitasthdpana (arrest of bleeding), 
Nirvdpana (cooling application), Utkarikd (massive 
poultices), Kashaya (washing with decoctions), Varti 
(lint or plug), Kalka (paste), Ghrita (application of 
medicated clarified butter), Taila (application of 
medicated oil\ Rasa-kriya (application of drug-extracts), 
Avachurnana (dusting with medicinal powders), Vrana- 
Dhupana (fumigation of an ulcer), Utsddana (raising of 
the margins or bed of an ulcer), Avasddana (destruction 
of exuberant granulation), Mridu-Karma (softening), 
Daruna-Karma (hardening of soft parts), Kshdra-Karma 
(application of caustics), Agni-Karma (cauterization), 
Krishna-Karma (blackening), Pandu-Karma (making 
yellow-coloured cicatrices), Pratisarana (rubbing with 
medicinal powders), Roma-sanjanana (growing of hairs), 
Lomdpaharana (epilation), Vasti-karma (application of 
enemas), Uttara-Vasti-karma (urethral and vaginal 
injections\ Vandha (bandaging), Patradana (application 
of certain leaves — vide Infra), Krimighna (Vermifugal 
measures\ Vrimhana (application of restorative tonics), 
Vishaghna (disinfectant or anti-poisonous applications), 
Siro-virechana (errhines), Nasya (snuff), Kavala- 
dharana (holding in the mouth of certain drug-masses for 
diseases of the oral cavity or gargling), Dhuma (smoking 



Chap. 1.] CHIKLITSA STHANAM. 245 

or vapouring), Madhu-sarpih (honey and clarified butter), 
Yantra (mechanical contrivances, e g., pulleys, &c.), 
Ahara (diet) and Raksha-Vidhana (protection from 
the influence of malicious spirits). 22. 

Of these, Kashaya, Varti, Kalka, Ghrita, Taila, Rasa- 
kriya and Avachurnana are the measures for the cleansing 
(Sodhana) of an ulcer and for helping its granulation 
(Ropana). The eight acts (from Chhedana to Sivana) 
are surgical operations. We have already spoken of 
such acts as Sonitasthapana, Kshara-karma, Agni- 
karma, Yantra, Ahdra, Raksha-vidhana and Vandha- 
Vidhana (in the Sutra-sth^na). Later on, we shall 
discourse on Sneha, Sveda, Vamana, Virechana, Vasti, 
Uttara-vasti, Siro-virechana, Nasya, Dhuma, and Kavala- 
dharana. Of the remaining measures we shall speak 
in the present chapter. 23. 

There are six kinds of swellings (Sophas), as described 
before, and the following eleven measures., commencing 
with Apatarpana and ending in Virechana, should be 
regarded as their cure. These are the proper remedies for 
a swelling and do not (cease to be efficacious in, nor) prove 
hostile to cases of swelling which are transformed into 
ulcers. The other measures should be deemed as 
remedial to ulcers but Apatarpana is the first, 
general and principal remedy in all types of swellings 
(Sophas). 24. 

Memorable Verses --—Apatarpana (fasting) 

should be prescribed in the case of a patient, full of 
enraged Doshas, as well as, in one having his organic 
principles (Dhatus) and refuse matters (Malas) of the 
system, deranged by them, for the purpose of bringing 
them to their normal condition, with a regard both 
to their nature and to the strength, age, &c., of the 
patient. Persons afflicted with diseases which result 



246 THE SUSHRUTA'SAMMITA. tChap. t. 

from the up-coursing of the'deranged Vayu(Urdhva-vata) 
such as cough, asthma, &c., or with thirst, hunger, 
dryness of the mouth and fatigue, as well as old men, 
infants, weak persons, men of timid dispositions and 
pregnant vvom^n should' never fast. A swelling and an 
extremely painful ulcer should be respectively treated 
with a proper medicated plaster at the very outset. The 
pain in such a case will yield to the medicinal plaster 
as a blazing room or house is readily extinguished by 
means of steady watering. Such plasters not only give 
comfort to the patient (by removing the pain and leading 
to the absorption of the swelling), but heaves up the bed 
of the sore or the ulcer and contributes to its speedy 
purification and healing up (granulation). 25—28. 

In the case of a swelling brought on by the deranged 
Vayu, the affected part should be washed or sprinkled 
(Parisheka) with a warm lotion of clarified butter, oil, 
Dhanyamla and essence of meat or with a decoction 
of the drugs that tend to pacify the enraged Vayu 
and to relieve the pain. A swelling due to the action of 
the deranged Pitta or blood or to the effect of 
a blow or poison should be washed or sprinkle 1 
with a lotion of milk, clarified butter, honey and sugar 
dissolved in water, the expressed juice of sugar-cane 
and a cold decoction of the drugs of the Madhura group 
(Kakol>'*adi-gana) and the Kshira-Vriksfias. A Kaphaja 
swelling on the body should be washed or sprinkled 
with a luke-warm lotion of oil, cow's urine, alkaline 
solution, wine >^Sura), Sukta and with a decoction of 
drugs that destroy the deranged Kapha. 29—31. 

IVIetrical Text : —As a fire is put out by jets of 
water, so the fire of the deranged morbific principles 
(Doshagnl) of the body are spe idily subdued and put down 
by the application of (medicinal lotions) washes. 32. 



Chap. I.] CHIKITSA STHANAM. 247 

An anointing (Abhyanga), duly prescribed and used, 
with a full regard to the nature of the aggravated 
Doshas, leads to their pacification (restoration to the 
normal condition) and to softness (subsidence) of the 
swelling. 33. 

lYICtrical Texts: — An application of an anoint- 
ment (Abhyanga) should precede the measures of fomen- 
tation, resolution, &c , while it should follow all evacuating 
measures, &c. A painful, extended and indurated swell- 
ing, as well as an ulcer of a similar nature, should be 
fomented, while an act of Vimlapana (resolution by 
gentle massage) should be done in respect of a fixed or 
unfluctuating swelling attended with little or no pain 
whatsoever. A wise physician should first annoint 
and foment the part and then gently and slowly press 
it with a bamboo-reed or with the back of his thumb 
or palm. A non-suppurated swelling or one that is 
partially suppurated should be treated with poultice 
(Upandha\ which would lead to its resolution or suppu- 
ration, as the case might be. A swelling, not resolved 
or not subsiding even after the adoption of the measures 
beginning with Apatarpana and ending in Virechana 
(in the given . list), should be caused to suppurate 
with the drugs enumerated in the ^chapter of Mis'raka, 
such as curd, whey, wine (Sura), Sukta and Dhany^mla 
(a kind of fermented paddy gruel). They should be 
formed into a paste and the paste should be cooked into 
an efficacious poultice-like composition:(Utk^rikd), and 
mixed with salt and oil or clarified butter, it should be 
applied over the affected part (swelling) and bandaged 
with the leaves of an Eranda plant. The patient 
should be allowed to take a wholesome (?^., which does 
not. produce Kapha) diet as soon as suppuration would 
set in (in the swelling), 34-39. 



248 THE SUSHRUTA SAMIilTA . [Chap. I. 

Blood-letting' :— Blood-letting should be re- 
sorted to in a case of newly formed swelling for 
its resolution and for alleviating the pain. Bleeding 
(Visratvana) is recommended in the case of an ulcer 
which is indurated, marked by a considerable swelling 
and inflammation and is reddish black or red-coloured, 
extremely painful, gagged in its shape and considerably 
extended at its base (congested), specially in the case 
of a poisonous ulcer, for the subsidence of the pain and 
for warding off a process of suppuratiou therein, either 
by applying leeches or by opening (a vein in the 
locality) by means of an instrument. An ulcer-patient 
of a dry or parched temperament affected with dis- 
tressing supervenients or ulcer-cachixia or who is weak 
should be made to drink an emulsive potion cooked 
with (a decoction of) appropriate drugs. A patient 
afflicted with an ulcer with an elevated margin and 
attended with swelling and specially marked by the 
presence of the deranged Kapha and by a flow of 
blackish red blood should be treated with emetics. 
Ulcer-experts recommend purgatives to a patient 
afflicted with an old or long-standing ulcer, attended 
with a deranged condition of the Vayu and Pitta. 
An excision should be made into an ulcer which refuses 
to suppurate and which is of a hard and indurated 
character attended with sloughing of the local nerves and 
ligaments (Snayu). An opening^ or excision (Bhedana) 
should be made into an ulcer (Vrana) in the inside of 
which pus has accumalated and makes it heave up and 
which not finding any outlet consequently eats into the 
underlying tissues and makes fissures and cavities. 40-46. 
Measures which contribute to a spontaneous bursting 
by medicinal applications (Da(rana) of a swelling should 
be adopted in the case of an infant or an old or enfeebled 



Chap, i.] CHlklTSA StHANAM. 249 

patient, or of one incapable of bearing the pain (of a 
surgical operation), or of a person of a timid disposition, 
as well as in the case of a woman, and in the case of 
swellings which appear on the vulnerable parts (Marmas) 
of the body. Remedies which lead to the spontaneous 
bursting of a swelling should be applied by a wise 
physician to a well-suppurated swelling drawn up and 
with all its pus gathered to a head ; or an alkaline 
substance should be applied on its surface and a 
bursting should be effected when the Doshas are found 
to be just aggravated by the incarcerated pus. 47. 

An ulcer which is indurated, whose edges are thick 
and rounded, which has been repeatedly burst open, 
and the flesh of whose cavity is hard and elevated, 
should be scarified by a surgeon ; or, in other words, 
an indurated ulcer should be deeply scarified, one 
with thick and rounded edges should be excessively 
scarified, while the one which has been repeatedly 
burst open should be entirely scraped off. An ulcer 
with a hard and elevated bed should be scraped evenly 
and longitudinally along the length of its cavity. In 
the absence of a scarifying instrument, the act should be 
performed with a piece of Kshauma (cloth made of the 
fibres of an Atasi plant), a linen (Plota) or a cotton pad 
(Pichu), or with such alkaline substances as nitrate of 
potash, Samudra-phena, rock-salt, or rough leaves of 
trees (e. g., those of Udumbara, &c.). 48. 

The cavities or courses of a sinus, or of an ulcer which 
had any foreign matter lying imbedded in its inside, or 
which takes a crooked or round about direction, as well as 
of the one formed into cavities within its interior, should 



* This scraping off of the ulcer should be done by an instrument of 
Surgery and not by any rough leaf or the like, nien'ioned hereafter. 

^2 



250 THE SUSHRUTA SAMHITA. [Chap, t 

be probed by gently introducing the tender fibres of 
bamboo sprouts (Karira), a (lock of) hair, a finger, or an 
indicator into its inside. The course of a sinus occurring 
about the anus or in the region of the eyes (Netra- 
Vartma) should be probed with the slender fibres 
of Chuchchu, Upodika, or Karira, in the event of 
their mouths being narrow and attended with bleeding. 
The Salya (incarcerated pus, etc.) should be extricated, 
whether the mouth of the sinus is constricted or other- 
wise, in conformityw ith the directions laid down before 
on that behalf. In diseases amenable to acts of punctur- 
ing (Vyadhana), the knife should be inserted into the 
seat of the disease to a proper depth and extent, to be 
determined by its situation in the body, and the 
Doshas (pus, etc.) should be let out, as stated before. 
Ulcers with a wide mouth, unattended with any symptoms 
of suppuration, and occurring in a fleshy part of the 
body, should be sutured up, and the adhesion (San- 
dhana) of the edges should likewise be effected, as direct- 
ed before. A plaster composed of drugs (capable of 
drawing out and secreting the pus), as described before, 
should be applied around the mouth of an ulcer seated 
in any of the Marmas (vulnerable parts), or full of pus 
in its inside, with a narrow-mouthed aperture. The 
plaster should be removed when dry, and should not 
be applied on the orifice of the ulcer, as it would, in that 
case, interfere with the spontaneous secretion of pus 
(Dosha). 49-54- 

An excessive haemorrhage incidental to such acts, as 
excessive hurting of the vein, etc., should be arrested with 
suitable styptic* measures and remedies (Sonitasthdpana). 



* Styptic measures are of four kinds— Sandhana,Skandana, Pachana, 
and Dahana. See Sutra- Sthanam, Chap. XIV. 



Chap. I.J CHIKITSA STHANAM. . 25 1 

An ulcer attended with fever, suppuration and burning 
sensation due to the excited state of the deranged 
Pitta and congestion of blood should be allayed (Nir- 
vapana — literally putting out) with suitable and proper 
medicinal remedies. It should be allayed with com- 
pounds made up of the proper cooling drugs (of the 
Mis'raka chapter), pasted with milk and lubricated with 
clarified butter. Cooling plasters (Lepa) should then be 
applied as well. 55-56. 

An ulcer whose flesh is eaten away, which discharges 
a thin secretion, or is non-suppurating in its character, 
and is marked by roughness, hardness, shivering and 
the presence of an aching and piercing pain, should 
be fomented with a poultice-like efficacious preparation 
(UtkairikaL )cooked with the drugs of Vayu-subduing 
properties, those included within the Amla-varga, and 
those which belong to the Kdkolyddi group, and with 
the oily seeds (such as linseed, sesamum, mustard, 
castor, etc.). An indurated, painful, faetid, moist and 
slimy ulcer should be washed with a disinfectant or 
purifying lotion consisting of a decoction of the drugs 
mentioned before for the purpose. 57-58. 

Plugs or lints plastered with a paste of the purifying 
drugs (enumerated before) should be inserted into an 
ulcer with any foreign matter (e.g., pus) lying embedded 
in it, or into one with a deep but narrow opening, or into 
one situated in a fleshy part of the body. An ulcer full 
of putrid flesh and marked by the action of the highly 
deranged Doshas (Vayu and Kapha) should be purified 
with a paste of the aforesaid available drugs making up 
the plug. An ulcer of a Pittaja origin, which is deep- 
seated and attended with a burning sensation and with 
suppuration, should be purified with the application of 
^ medicated clarified butter, prepared with the purifying 



252 THE SUSHRUTA SAMHITA. tChap. I. 

drugs with an admixture of Kdrpasa-phala*. An 
intelligent Surgeon should purify an ulcer with raised 
flesh, and which is dry and is attended with scanty 
secretion with an application of medicated mustard oil. 
An indurated ulcer, refusing to be purified with the fore- 
going medicated oils, should be purified with a duly 
prepared decoction of the drugs enumerated before 
(Sutra, chap. 38,— the Salas^rddi group) and prepared in 
the following manner of Rasa-kriyat. A decoction of 
the said drugs duly prepared should be saturated with 
an after- throw of Haritdla, Manahs'ild, Kdsisa and 
Smirdshtra earth, and well compounded together ; the 
preparation should also be mixed with the expressed 
juice of Mdtulunga and with honey. The medicine thus 
prepared should be applied to the ulcer on every third 
or fourth day. 59. 

Deepf and foul-smelling ulcers covered with layers 
of deranged fat (phlegmonous ulcer) should be purified 
by the learned physician with the powders of the drugs 
with which the purifying plug or the lint has been 
enjoined to be plastered (Ajagandha, &c.). Decoctions 
of the drugs which are possessed of the virtue of setting 
in a process of granulation (Ropana) in an ulcer, sucn 
as Vata, &c., as stated before, should be used by a 
surgeon (Vaidya) after it had been found to have been 
thoroughly purified. Medicated plugs, composed of 
drugs possessing healing properties (such as, So7na,Amritd, 
As'vagandhd^ etc}) should be inserted in deep-seated ulcers, 
when cleansed and unattended with pain. 60-62. 

* The total weight of the purifying drugs should be equal to that of 
the Karpasa-phala alone and they should be boiled together with four times 
their qnantity of clarified butter and with sixteen times of water. 

t There is a difTerent reading of "Agambhira" in place of "Gabhira," 
but Gayi thinks the emendation undesirable. 



Chap. I.] CHIKITSA STHANAM. 2^3 

A Kalka or a levigated paste of sesamum and 
honey (mentioned in the Misraka Chapter) should be 
applied for the purpose of healing up an ulcer situated 
in a muscular part from which all putrid flesh has 
been removed or sloughed off and which exhibited a clear 
cavity. This paste (of sesamum) tends to allay the 
deranged Vayu through its sweet taste, oleaginous- 
ness and heat-making potency ; subdues the deranged 
Pitta through its astringent, sweet and bitter taste and 
proves beneficial even in the case of the deranged 
Kapha through its heat-producing potency and bitter 
and astringent taste. An application of the levigated 
paste of sesamum mixed with the drugs of purifying and 
healing properties tends to purify and heal up an ulcer. 
An application of the levigated paste of sesamum mixed 
with honey and Nimda-\es.ves leads to the purification 
of sores ; whereas an application of the same paste 
(?> , sesamum, honey and leaves of Nimbd), mixed with 
clarified butter tends to heal up the ulcer. Several 
authorities atribute the same virtue to a barley-paste.* 
Levigated pastes of barley and of sesamum (or a paste of 
barley mixed with sesamum) contribute to the resolution 
or subsidence of a non-suppurated swelling, fully suppur- 
ate one which is partially suppurated, lead to the spon- 
taneous bursting of a fully suppurated one, and purify 
as well as heal up one that has already burst out. 63-65. 

An ulcer,whicb is due to the effects of poison, vitiated 
blood, or aggravated Pitta, and which is deep-seated oris 
of traumatic origin, should be healed up with a medicated 
clarified butter prepared with the drugs of healing virtues 
(Ropaniya— enumerated before) and milk. An ulcer 
marked by an aggravated condition of the deranged 

Jejjada and Gayadasa interpret the term to mean '*barley-paste 
mixed with sesamum." 



254 THE SUSHRUTA SAMHITA. [Chap. I. 

Vayu and Kapha should be healed up with the applica- 
tion of an oil, boiled and prepared with the proper 
purifying drugs mentioned before. 66 6y. 

Rasa-kriyat* with the two kinds of Haridrd should 
be resorted to for the purpose of healing up an ulcer, in 
which bandaging is forbidden (such as those due to the 
deranged Pitta or blood, or to blow, &c., or to the effects 
of poison), and an ulcer appearing on the moveable 
joints, which, though exhibiting all the features of 
a well-cleansed sore, has not been marked by any process 
of healthy granulationf. Healing medicinal powders 
should be used in the case of an ulcer which is con- 
fined to the skin, and is firm-fleshed and marked by 
the absence of any irregularity in its shape {i.e.^ not 
uneven in its margin). The mode of applying medicinal 
powders, as stated in the Sutra-sthana, should be adopted 
in the present instance. 68-69. 

The healing and purifying measures described above 
should be deemed equally applicable to, and efficacious 
in cases of ulcers in general with regard to their 
Doshas (both idiopathic and traumatic). The success 
of these measures has been witnessed in thousands of 
cases and has been recorded in the Sastras (authorised 
works on medicine). Hence they should be used as 
incantations without any doubt as to their tested and 
infallible efficacy. An intelligent physician should 
employ the drugs, mentioned before, in any of the 
seven forms (either in the shape of a decoction, or a 

* The decoction of IriphalA and the drugs of the Nyagrodhadi group 
should be duly prepared, filtered and then condensed to the consistency of 
tteacle. Powders of Haridrd and Daru-haridra should be then thrown 
into it. In the end, the whole preparation should be well-stirred, 
mixed with honey and applied. This is what is called Rasa-kriya. 

t Several editions read "though cleansed yet ungranulating ulcere." 



Chap, t] CHlklTSA STHANAM. 2^5 

plug, or a paste, or through the medium of medicated oils 
and clarified butter, or in the shape of Rasa-kriya, or as 
powders), according to the requirements of each case. 70. 

The drugs which constitute the two groups ofPancha- 
mulas (major and minor), as well as those of the Vayu- 
subduing group, should be employed in the case of an ulcer 
due to the aggravated Vatyu in any of the seven forms 
— decoction, etc. Similarly the drugs which are included 
within the groups of Nyagrodhadi or Kakolyadi should 
be used in any of those seven forms, in the case of an 
ulcer due to the aggravated Pitta (for the purification 
and healing thereof). Drugs which form the group of 
Aragvadhadi, as well as those which have been des- 
cribed as heat-making in their potency, should be used 
in any of those seven aforesaid forms, in the case of 
an ulcer due to the deranged Kapha. The drugs of two 
or three of those groups, should be combinedly used 
in any of those seven forms, in connection with an 
ulcer marked by the aggravated condition of any two 
or three of the deranged Doshas respectively. 71-74. 

Fumig'ation : — Vataja ulcers with severe pain 
and secretion should be fumigated with the fumes of 
Ks/iauma, barley, clarified butter and other proper fumi- 
gating substances [such as turpentine and resin (gum of 
Sdlatree)]. 75. 

Utsadana-Kriya (Elevation) :— Medicated 
plasters (consisting of Apdmdrga, As'va^andhd, etc.) and 
medicated clarified butter (prepared with the same 
drugs should be used in ulcers (due to the aggravated Vayu 
and marked by the absence of any secretion, and affecting 
a considerably smaller area or depth of flesh, as well 
as in those (due to the deranged and aggravated Pitta 
and) seated deep into the flesh, for the purpose of raising 
up (filling up) the beds or cavities thereof. Meat of carni- 



256 THE SUSHRUTA SAMHITA. tChap. t. 

vorous animals should be taken in the proper manner by 
the patient, inasmuch as meat properly partaken of in 
a calm and joyful frame of mind adds to the bodily flesh 
of its partaker. J6. 

Ava.Sada.na (destruction of super-growths) : — 
Proper drugs or articles (such as sulphate of copper, 
etc.) powdered and pasted with honey should be applied 
for destroying the soft marginal growths of an ulcer 
found to be more elevated than the surrounding surface 
of the affected locality. 77. 

IVI rid U- Karma (softening) :— In respect of 
indurated and fleshless (not seated in a part of the body 
where flesh abounds) ulcers marked by a deranged 
condition of Vayu, softening measures (with the 
help of repeated applications of lotions and plasters 
composed of sweet and demulcent substances mixed 
with salt in a tepid or luke-warm state) and blood- 
letting* should be resorted to. Sprinkling (Seka) and 
application of clarified butter or oil prepared with the 
Vayu-subduing drugs should also be resorted to. yZ. 

D^runa-karma:— The employment of harde- 
ning measures (Daruna-karma) is efficacious in con- 
nection with soft ulcers and in the following man- 
ner. Barks of Dhava, Priyangu, As' oka, Rohini^ 
Triphala, Dhdtaki flowers, Lodhra and Sarjarasa^ taken 
in equal parts and pounded into fine powders, should be 
strewn over the ulcer, i.e., the ulcer should be dusted 
with the same. 79. 

Kshara- Karma (Potential cauterization) : — 
The measure of applying alkali should be adopted for the 

* Blood-letting should be resorted to in the event of any vitiated 
blood being found to have been involved in the case ; but in the event of 
a similar participation of any deranged Kapha, oils and lotions composed 
of the Va'yu-destroying drugs should be made use of. 



Chap. I.] CHIKITSA STHANAM. 257 

purification of the sore of a long-standing ulcer which is 
of an indurated character with its margin raised higher 
(than the surrounding skin), and is marked by itching 
and a stubborn resistance to all purifying medicines. 80. 
Agni-Karma (actual cauterization) :— An ulcer 
incidental to an act of lithotomic operation allowing the 
urine to dribble out through its fissure, or one marked 
by excessive bleeding, or in which the connecting ends 
have been completely severed, should be actually cauter- 
ised with fire. 81 . 

Krishna- Karma : -The blackening of a 
white cicatrix, which is the result of a bad or defective 
granulation, should be made (after the complete healing 
up of the ulcer) in the following manner. Several Bhalld' 
taka seeds should be first soaked in the urine of a cow 
(and then dried in the sun, this process should be 
repeated for seven days consecutively), after which they 
should be kept (a week) immersed in a pitcher full of 
milk. After that the seeds should be cut into two and 
placed in an iron pitcher. Another pitcher should be 
buried in the ground with a thin and perforated lid 
placed over its mouth, and the pitcher containing the 
seeds should be placed upon it with its mouth downward 
(so that the mouths of the two pitchers might meet), and 
then the meeting place should be firmly joined (with 
clay). This being done a cow-dung fire should be lit 
around the upper pitcher. The oily matter (melted by 
the heat) and dribbling down from the Bhallataka seeds 
into the underground pitcher should be slowly and care- 
fully collected. The hoofs of village animals (such as 
horses, etc.) and those which live in swamps (Anupas — 
such as buffaloes, etc.) should be burnt and pounded 
together into extremely fine powder. The oil (of the 
Bhalldtaka seeds collected as above) should then be 



258 THE SUSHRUTA SAMHITA. [Chap. I. 

mixed with this powder, and applied to the white 
cicatrix. Similarly, the oily essence of the piths of 
some kinds of wood, as well as of some kinds of fruit 
{Phala-snehd) prepared in the manner of the Bhalldtaka 
oil (and mixed with the powdered ashes of hoofs) should 
be used for the blackening of a cicatrix. 82-83. 

PandU-karana :— The natural and healthy 
colour (Pdndu) of the surrounding skin should be im- 
parted to a cicatrix which has assumed a black colour 
owing to the defective or faulty healing up of the sore in 
the following manner. The fruit of the Rohini* should be 
immersed in goat's milk for seven nights and, afterwards 
finely pasted with the same milk, should be applied 
to the skin. This measure is called Fandu-karana 
(imparting a yellow or natural skin-colour to the 
cicatrix). To attain the same result, the powder of a 
new earthen pot, Vetasa roots, S'dla roots. Sulphate of 
iron, and Madhuka (Yashti-madhu) pasted together with 
honey may be used. As an alternative, the hollow rind 
of the Kapittha fruit, from which the pulp has been 
removed, should be filled with the urine of a goat to- 
gether with Kasisa (Sulphate of iron), Rockand, Tuttham 
(Sulphate of copper). Haritdla^ Manahsild, scrapings 
of raw bamboo skin, Prapunndda (seeds of Chakunde), 
and Rasanjana and buried a month beneath the roots 
of an Arjuna tree after which it should be taken out 
and applied to the black cicatrix. The shell of a hen's 
egg, Kataka^ Madhuka, (Yashti-madhu), sea-oysters and 
crystalsf (pearls according to Jejjata and Brahmadeva) 
taken in equal parts should bs pounded and pasted with 



• Rohini, according to som^ co nmentators, means a kind of Haritaki ; 
according to others, it means Ka*u-tumbi. 

I Burnt ashes of sea-oysters, and pearls etc., should be used. 



Chap. I.] CHIKITSA STHANAM. 2^9 

the urine of a cow and made into boluses which should 
be rubbed over the cicatrix * 84-87. 

Roma-Sanjanana— hair-producers :— The 

burnt ashes of ivory and pure Rasdnjana (black 
antimony; pounded (and pasted with goat's milk) should 
be applied to the spot where the appearance of hair 
{Lomotpatti) is desired. An application of this plaster 
would lead to the appearance of hair even on the palms 
of the hands. Another alternative is a pulverised 
compound consisting of the burnt ashes of the bones, 
nails, hair, skin, hoofs and horns of any quadruped, 
over a part of the body, previously anointed (rubbed) 
with oil, which would lead to the appearance of hair in 
that region. And lastly, a plaster composed of Sulphate 
of iron, and tender Karanja leaves pasted with the 
expressed juice of Kapittha, would be attended with 
the same result. 88 — 90. 

Hair-dcpilators '.—The hair of an ulcer- 
ated part of the body found to interfere with the satis- 
factory healing up of the ulcer, should be shaved with 
a razor or clipped with scissors, or rooted out with the 
help of forceps. As an alternative, an application of a 
plaster consisting of two parts of pulverised (burnt ashes 
of) conch-shell and one part oi Haritdla (yellow orpiment 
or yellow oxide of arsenic) pasted with Sukta (an 
acid gruel) over the desired spot, would be attended 
with the same result A compound made of the oil of 
Bhallattaka mixed with the milky exudation of Snuhi, 
should be used by an intelligent physician as a depila- 
tory measure. As an alternative, the burnt ashes of the 
stems of plantain leaves and Dirghavrinta (Syondka) 
mixed with rock-salt, Haritdla and the seeds of Sami, 

* This also is a remedy for giving a natural colour to the skin. 



26o THE SUSHRtJTA SAMHITA. [Chap. I. 

pasted with cold water, should be deemed a good hair- 
depilatory.* A plaster composed of the ashes of the 
tail of a domestic lizard, plantain, Haritala (oxide of 
arsenic), and the seeds of Ingudi burnt together: and 
pasted with oil and water, and baked in the sun may 
also be used for the eradicating of hair in the affected 
locality. 94-95. 

Vast! -Karma :— A medicated Vasti (enema) 
should be applied to the rectum in the case of an ulcer 
marked by an aggravated condition of the deranged 
Vayu which is extremely dry and is attended with an 
excruciating pain occurring specially in the lower region 
of the body. A measure of Uttara-vasti (Vaginal or 
Urethral syringe) should be adopted in the cases of 
strictures and other disorders connected with urine, 
semen and menstruation, as well as in cases ot 
gravel ^ in case these are due to an ulcer. An ulcer is 
purified, softened and healed up by bandaging leaving 
no room for the apprehension of a relapse. Hence 
bandaging is recommended. 96-98. 

Patradana (application of leaves on an ulcer) : — 
Leaves possessed of proper medicinal virtues taking 
into consideration the particular Dosha and season of the 
year should be tied (over the medicinal plaster applied) 
over an ulcer of non-shifting or non-changing character 
and not affecting a large depth of flesh and which 
refuses to be healed up owing to its extreme dryness. 
An ulcer of the deranged Vayu should be tied over with 
the leaves of the Eranda, Bhurfa, Putika, or Haridrd 
plants as well as with those of the Upodikd and 
Gdmbhdri. An ulcer marked by an aggravated condition 

* According lo seme this may be used internally for the purpose. 

t D. R. Some read "Tathaiiiile" in place of ♦•As'mari-vrane." 

."Taiharjile" means and in cases of (aggravated) Vayu. 



Chap. I.] CHIKITSA STHANAM. 26l 

of the deranged Pitta, or incidental to a vitiated condi- 
tion of the blood, should be tied in the aforesaid manner 
with the leaves of the Kds'mari, the Kshira trees (milk- 
exuding trees), and aquatic plants. An ulcer due to the 
deranged and aggravated Kapha, should be tied over 
with the leaves of the Pdthd, Murvd, Guduchi, Kdka- 
mdchi, Haridrd or of the S'ukandsd, Only those leaves 
which are not rough, nor putrid, nor old and decomposed, 
nor worm-eaten and which are soft and tender should.be 
used for purposes of Patradana.* The rationale of such 
a procedure (Patra-vandha) is that the leaves tied by an 
intelligent physician in the manner above indicated 
serve to generate heat or cold and retain the liniment 
or medicated oil in their seat of application. 99-102. 

Vermifugal :— The germination of worms due 
to flies in an ulcer is attended with various kinds of 
extreme pain, swelling and bleeding in case the worms 
eat up the flesh. A decoction of the drugs of the 
Suras ddi gana proves efficacious as a wash and healing 
medicine in such a case. The ulcer should be plastered 
with such drugs as the bark of Saptaparna, Karanja, 
Afka, Nimba, and Rdjddana pasted with the urine of a 
cow, or washed with an alkaline wash (for expelling the 
vermin from it). As an alternative, the worms should be 
brought out of the ulcer by placing a small piece of raw 
flesh on the ulcer. These vermin may be divided into 
twenty groups or classes, which will be fully dealt with 
later on. (Uttara-Tantram- ch. 54). 103. 

Vrinhanam (use of restorative and constructive 
tonics) : — All kinds of tone-giving and constructive 
measures should be adopted in the case of a patient 

The leaf which does not poison the Sneha and the esserxe of the 
medicinal drugs placed in a folded piece of linen (and applied over an 
ulcer is the proper leaf and) should be used for tying over the paste. 



262 THE SUSHRUtA SAMHITA. [Chap. t. 

weak and emaciated with the troubles of a long-standing 
sore, taking full precaution not to tax his digestive 
powers. Anti-toxic (Vishaghna) medicines and measures 
and symptoms of poisonings will be described under 
their respective heads in the Kalpa-Sthanam. 104-105. 

^iro-vircchana and Nasya :-S'iro-vire- 

chana measures (errhines) should be resorted to by 
skilful physicians in respect of ulcers situated in the 
clavicle regions and marked by itching and swelling. 
The use of medicated (fatty) snufF (Nasya) is recom- 
mended in cases where the ulcers would be found to be 
seated in the regions above the clavicles and marked by 
an aggravated condition of the deranged Vayu, pain, 
and absence of the oily matter. 106-107. 

Kavala-dharana :— Medicated gargles (^con- 
sisting of decoctions of drugs) of purifying or healing 
virtues either hot or cold * (according to require- 
ments) should be used in the case of an ulcer in the 
mouth, for the purpose of alleviating the Doshas therein, 
for allaying the local pain and burning, and for removing 
the impurities of the teeth and the tongue. 108. 

Dhuma-pana : —inhaling of smoke or vapours 
(of medicated drugs) should be prescribed in cases of ulcers 
of the deranged Vayu and Kapha attended with swelling, 
secretion and pain and situated in the region above the 
clavicles. Application of honey and clarified butter, se- 
parately or mixed together should be prescribed in cases 
of extended or elongated ulcers which are traumatic or 
incidental in their character (Sadyo-Vrana) for allaying 
the heat of the ulcer and for bringing about its adhe- 
sion . Surgical instruments should be used in connec- 

* Hot gargles are recommended in cases of ulcers of the deranged 
Vayu and Kapha while cold ones in cases of ulcers of the aggravated Pitta 
and blood. 



Chap. I.] CHIKITSA STHANAM. 263 

tion with an ulcer which is deep-seated but provided 
with a narrow orifice and which is due to the pene- 
tration of a Salya (shaft) and which could not be re- 
moved with the hand alone. 109-111. 

The diet of an ulcer-patient should in all cases be 
made to consist of food which is light in quantity 
as well a? in quality, demulcent, heat-making (in potency) 
and possessed of appetising properties* Protective rites 
should be performed for the safety of an ulcer-patient 
from the influences of malignant stars and spirits with 
the major and the minor duties (Yama and Niyama) 
enjoined to be practised on his behalf. 112-113. 

The causes of ulcers are sixf ; their seats in the 
body number eight| in all ; the features which charac- 
terise them are five $. The medicinal measures and 
remedies in respect of ulcers are sixty Ij in number. 
And these ulcers are curable with the help or co-opera- 
tion of the four necessary factors (the physician, the 
medicines, the nurse and the patient). 114. 

The comparatively smaller number of drugs which 
I have mentioned (under the heads of Ropana, 
Sodhana, etc., in the present chapter) from fear of 
prolixity, may be increased in combination with other 
drugs or substances of similar virtue, (digestionary trans- 
formation and potency, etc.) without any apprehension 

* See Chap. XIX.— Sutra-Sthanam. 

t The six causes of an ulcer are Vayu, Pitta, Kapha, Sannipdta, 
S'onita aud Agantu. 

t The eight seats of an ulcer are Tvak, Mansa, S'ira, Snayu, Sandhi, 
Asthi, Koshlha and Marma. 

§ The five symptoms of an ulcer are due to Vata, Pitta, Kapha, 
Sannipata and Agantu. The symptoms due to S'onita being identical 
with those due to Pitta, are not separately counted. 

II The sixty medicinal measures and remedies are those describee^ 
before in the present chapter. 



264 THE SUSHRUTA SAMHITA. [Chap. I. 

of doing any mischief thereby. Recipes consisting 
of rare or a large number of drugs or ingredients, 
should be made up with as many of them as would be 
available in the absence of all of them, as mentioned 
in the present work. A drug belonging to any parti- 
cular Gana or group if separately described as non- 
efficacious to any specific disease, should be omitted 
whereas a drug not belonging to a group may be added 
to it if it is elsewhere laid down as positively beneficial 
thereto. 11 5-1 17. 

Upadrava : — The distressing supervening symp- 
toms which are found to attend a case of ulcer, are quite 
different from those of an ulcer-patient. Those which 
confine themselves solely to the ulcer are five in all — 
smell, colour, etc., and those which are exclusively mani- 
fest in the patient are fever, diarrhoea, hiccup, vomit- 
ing, fainting fits, aversion to food, cough, difficult 
breathing, indigestion and thirst. The medical treat- 
ment of ulcers though described in detail in the present 
chapter, will be further dealt with in the next chapter 
on Sadyo-Vrana. 118-120. 

Thus ends the first Chapter of the Chikitsita-Sthanam in the Sus'ruta 
Samhita which deals with the treatment of the two kinds of ulcer. 



CHAPTEK II. 

Now we shall discourse on the medical treatment of 
recent or traumatic wounds or sores (SadyOVrana- 

Chikitsa). i, 

Metrical Texts; -The holy Dhanvantari, the 
foremost of the pious and the greatest of all discoursers, 
thus discoursed to his disciple Susruta, the son of 
Visvdmitra. 2. 

Different Shapes Of Sores :— I shall de- 
scribe the shapes of the various kinds of Vrana (sores 
or wounds) caused by weapons of variously shaped edges 
in the different parts of the human body. Traumatic 
ulcers have a variety of shapes. Some of these are 
elongated, others are rectangular, or triangular, or 
circular, while some are crescent shaped, or extended, or 
have a zigzag shape, and some are hollow in the middle 
like a saucer, and lastly some have she shapes of a 
barley corn (bulged out at the middle). An abscess 
or a swelling, due to the several Doshas and which 
spontaneouly bursts out, may assume any of the aforesaid 
forms, while the one effected by a surgeon's knife should 
never have a distorted or an improper shape. A surgeon 
thoroughly familiar with the shapes of ulcers is never 
puzzled at the sight of one of a terrible and distorted 
shape. 3 — 5. 

Physicians of yore have grouped these variously 
shaped traumatic ulcers under six broad sub-heads, such 
as the Chhinna (cut), Bhinna (punctured or perforated), 
Viddha (pierced), Kshata (contused), Pichchita (crushed), 
and the Ghrishta (mangled or lacerated) according to 
their common features and I shall describe their 
symptoms. 6. 

34 



266 THK SUSHRUTA SAMIIITA. [Chap. II. 

Their definitions:— A traumatic ulcer which 
is oblique or straight and elongated is called a Chhinna 
l^cut) ulcer, while a complete severance of a part or 
member of the body is also designated by that name, 
A perforation of any of the cavities or receptacles of 
the body by the tip of a Kunta, spear, Rishti, or a sword 
or by a horn, attended with a little discharge, constitutes 
what is called a Bhinna (punctured) wound or ulcer. 
The Amas'aya (stomachy the Pakv^saya (intestines), the 
Agnyasaya (gall-bladder ?\ the Mutras'aya (urinary 
bladder), the Raktasaya (receptacle of blood), the heart, 
the Unduka and the lungs constitute what is called the 
Koshtha (viscu>). A perforation (of the wall of any) 
of the As'ayas causes it to become filled with blood 
which is discharged through the urethra, the anus, the 
mouth or the nostrils and is attended with fever, thirst, 
fainting fits, dyspnoea, burning sensations, tympanites, 
suppression of stool, urine and flatus (Vata) with an 
aversion for food, perspiration, redness of the eyes, a 
bloody smell in the mouth, and feted one in the body 
and an aching pain in the heart and in the sides. 7 — 10. 

Now hear me discourse on (their) detailed symptoms. 
A perforation of the wall of the Ama'saya (stomach) is 
marked by constant vomiting of blood, excessive 
tympanites and an excruciating pain. A perforation of 
the Pakva's'aya fills it with blood and is attended with 
extreme pain, a heaviness in the limbs, coldness of the 
sub-umbilical region, and bleeding through the (lower) 
ducts and orifices of the body. Even in the absence of 
any perforation, the Antras (intestines) are filled with 
blood through the small pores or apertures in their walls 
in the same manner as a pitcher with its mouth firmly 
covered may be filled through the pores (in its sides), and 
a sense of heaviness is also perceived in their inside, r i-i 3. 



Chap. 110 CHIltlTSA STHANAM. '267 

A wound or an ulcer caused by any sharp pointed 
Salya (shaft) in any part of the body other than the 
aforesaid As'ayas with or without that Salya being extri- 
cated is called a Viddha (pierced one). An ulcer which 
is neither a cut nor a perforation or puncture but partakes 
of the nature of both and is uneven is called a Kshata 
(wound). A part of the body with the local bone 
crushed between the folds of a door or by a blow be- 
comes extended and covered with blood and marrow and 
is called a Pichchita (thrashed) wound or ulcer. The 
skin of any part of the body suffering abrasion through 
friction or from any other such like causes and attended 
with heat and a secretion is called a Ghrisbta (mangled 
or lacerated) wound or ulcer. 14-17. 

Their Treatment : —A part or member of the 
body any wise cut, perforated, pierced or wounded which 
is attended with excessive bleeding and with the local 
Vayu enraged or aggravated by the incidental bleeding, 
or haemorrhage will occasion excruciating pain. Potions 
of Sneha (oily or fatty liquids) and using the same as a 
washing (in a lukewarm state) should be advised in such 
cases. Preparation of Ves'avaras and other Krisaras 
largely mixed with oil or clarified butter should be used 
as poultices and fomentations with the Masha pulse, 
etc., and the use of oily ungents and emulsive Yastis 
(enematas)* prepared with decoctions of Vayu-subduing 
drugs should be applied. A crushed or thrashed wound 
or abrasion is not attended wi:h any excessive bleeding 
an absolute absence whereof, '^on the contrary) gives rise 
to an excessive burning sensation and suppuration in 
the affected part. Cold washes and cooling plasters 
should be used in these cases for the alleviation of the 

* Snehapana is recommended when the ulcer is in a region above the 
umbilicus and Vasti-karma when the ulcer is in a subumbilical region. 



268 THE SUSHRUTA SAMHITA. [Chap. IT, 

burning and suppuration as well as for the cooling of 
the (incarcerated) heat. What has been specifically 
said of these six forms of ulcers, or wounds should be 
understood to include the treatment of all kinds of trau- 
matic wounds or ulcers as well. i8 — 20. 

Treatment of cuts or incised wounds 

&C : — Now we shall discourse on the medical treatment 
of Chhinna cuts. An open mouthed ulcer on the side 
of the head* should be duly sutured as described before 
and firmly bandaged. An ear severed or lopped off 
should be sutured in the proper way and position and 
oil should be poured into its cavity. A Chhinna cut on 
the Krikatika (lying on the posterior side of the junction 
of the neck and the head) and even if it allow the 
V^yu t (air) to escape through its cavity should be 
brought together and duly sutured and bandaged in a 
manner (so as not to leave any intervening space 
between\ The part thus adhesioned should be sprinkled 
with clarified butter prepared from goat's milk. The 
patient should be made to take his food lying on his 
back, properly secured or fastened with straps (so that he 
might not move his head and advised to perform all 
other physical acts such as, urination, defecation etc , in 
that position). 21-24 

In the case of a lateral and wide-mouthed wound 
(sword-cut, etc.) on the extremeties, the bone-joints 
should be duly set and joined together as instructed 
before and the wound should be sutured and speedily 
bandaged in the manner of a Vellitaka bandage, or 

* Several commentators explain those that are situated either on the 
head or on the sides. 

t The dictum that a hurl on any of the wind-carrying sounding chan- 
nels is pronounced to be incurable, should not be supposed to hold good 
in the present case. 



Chap. II.] CHIKITSA STHANAM. 269 

with a piece of skin or hide in the Gophana or such 
other form as would seem proper and beneficial and oil 
should be poured over it. In the case of a wound on 
the back the patient should be laid on his back, while in 
the case of its occurring on the chest the patient should 
be laid on his face* 25-27. 

In the case of a hand or a leg being carried away or 
completely severed the wound should be cauterised with 
the application of hot oil and bandaged in the manner 
of a Kosha bandage and proper healing medicines 
should be applied. An oil cooked with the eight drugs 
Chandana, Padmaka, Rodhra, Utpala, Priyan^u, Haridrd, 
Madhuka^ (Yasthimadhu) and milk, forms one of the 
most efficacious healing (Ropana) agents A Kalka of 
the thirteen drugs — Chandana, Karkatdkhya, the two 
kinds of Sahd (Mugani and Mashani), Mdnsi, (D.R. — 
Mashahva, Somahva), Amritd, Hatenu, Mrindla 
Triphald^ Padmaka and Utpala should be cooked in 
oil mixed with milk (four times that of oil) and the three 
other kinds of oily matter (lard, marrow and clarified 
butter) and this medicated oil should be used for 
sprinkling over a wound of this type for the purpose of 
healing (Ropana). 28. 

IVIedical Treatment of Bhinna :— 

Henceforth we shall deal with the medical treatment 
of Bhinna (excised) wounds. A case of an excised eye 
(Bhinna) should be given up as incurable. But in 
the case where an eye (ball) instead of being completely 
separated would be found to be dangling out (of its 

* For the complete elimination of the deranged Dosha i.e,^ pus, eic , 
of the wound invloved in the case — Jejjata. 

He who has got a wound on his back should be laid on his face and 
he who has got an ulcer on his breast should be laid on his back — 
Dififereut Reading Gayi. 



2^0 THE SUSHRUTA SAMHITA. [Chap. It. 

socket) the affected organ should be re-instated in its 
natural cavity in a manner so as not to disturb the 
connected Siras (nerve arrangements) and gently pressed 
with the palms of the hand by first putting a lotus leaf 
on its (eye) surface. After that the eye should be filled 
(^Tarpana) with the following (D.R, - Ajena in place of 
'Anena' — i.e., prepared from goat's milk) medicated 
clarified butter, which should be as well used in the 
form of an errhine. The recipe is as follows : — Clarified 
butter prepared from goat's milk, Madhuka, Utpala, 
fivaka and Rishavaka taken in equal parts should 
be pasted together, and cooked with sixteen seers of 
cow's milk and four seers of clarified butter.* The 
use of the medicated Ghrita thus prepared should be 
regarded as commendable in all types of occular hurt or 
injury. 29. 

In the case of a perforation of the abdomen marked 
by the discharge of lumps or rope-like Varti (fat) 
through the wound, the emitted or ejected fat-lump 
should be dusted with the burnt ashes (D. R. -powders) 
of astringent woods (such as Manu, Arjuna, etc.) and 
black clay (pounded together). A ligature of thread 
should then be bouid round the fat-lump and the fat- 
lump cut off with a heated instrument. Honey should 
then be applied and the wound (Vrana) should then 
be duly bandaged. The patient should be caused 
to drink clarified butter after the full digestion of his 
injested food. Instead of this Ghrita, milk prepared 

* Several authorities, however, say that equal parts of clarified 
butter prepared from goat's milk and from cow's milk should be taken and 
cooked with l6 seers of cow's milk and with the four drugs as a Kalka. 

Bui Gayi recommends only four seers of clarified butler prepared from 
goat's milk cooked with 16 seers of cow's milk and the four drugs as 
a Kalka. 



I 



Chap. II.] CHIKITSA STHANAM . 27 1 

medicinally with Yashtimadchi, Ldkshd and Gokshura^ 
mixed with (a proper quantity of) sugar and castor oil 
(as Prakshepa)* is equally commendable for the alle- 
viation of the pain and the burning sensation, (in the 
wound or ulcer). The fat-lump (pariental fat) afore- 
said causes a rumbling sound with pain in the abdomen 
and may prove even fatal in the event of its being left 
uncut. The medicated oil to be mentioned hereafter 
in connection with Medaja-Granthi should be applied 
in such cases. 30-32 

Foreign bodies t^Salya) piercing into any of the 
Koshthas after having run through the (seven layers of; 
skin, whether passing through the veins, etc ^ (muscles, 
nerves, bones or joints or not, produces the distressing 
symptoms described before (Ch. III. — Sutra). The blood 
(of the affected chamber or receptacle) in such case lies 
incarcerated therein in the event of its failing to find an 
outlet and causes a paUor of the face and a coldness of the 
extremities and of the face in the patient. Respiration 
becomes cold, the eyes red-coloured, the bowels consti- 
pated and the abdomen distended. The manifestation 
of these symptoms indicates the incurable character of 
the disease. 33-34. 

• This explanation is given on the authority of old Vagabhata. 
Dallana, however, explains the verse in a different way. He explains it 
to mean two different preparations of milk— one with Yashti-madhu and 
mixed with sugar and castor oil as a Prakshepa and the other with 
Gokshura and mixed with Laksha and castor oil as a Prakshepa. 

A third in'erprctation would make three preparations of milk prepared 
separately with Yashti-madhu, Laksha and Gok&hura — sugar and castor 
oil being mixed in the first (as Prakshepa) and castor oil alone in the 
second and third. 

A fourth preparation would be to prepare the milk separately wiih 
Yasbtimadhu, Laksha and Gokshura as in the preceding case— without the 
Addition of castor oil (as Prakshepa), 



272 THE SUSHRUTA SAMHITA. [C^ap. II. 

Emesis is beneficial in the case where the blood 
would be found to be confined in the Am as ay a 
(stomach). Purgatives should unhesitatingly be pre- 
scribed where the blood would be found to have been 
lodged in the Pakvas'aya (intestines) and Asthapana 
measures without oil should be employed with hot, 
purifying i^Sodhana) substances (such as the cow-urine, 
etc.) The patient should be made to drink a Yavagu 
(gruel) with Saindhava salt and his diet should consist 
of boiled rice mixed with the soup of barley, Kola and 
Kulalttha pulse divested of oil. 35-36. 

In a case of a perforation or piercing of any of the 
bodily Koshthas attended with excessive haemorrhage 
or bleeding, the patient should be caused to drink (a 
potion of animal) blood and such a case marked by the 
passage of stool, urine, etc., through their proper channels 
of outlet and by the absence of fever and tympanites 
and other dangerous symptoms, (Upadrava), may end 
in the ultimate recovery of the patient. 37-38. 

In a case of a perforation of the Koshtha (abdomen) 
where the intestines have protruded or bulged out in an 
untorn condition, they should be gently re-introduced 
into the cavity and placed in their original position, 
and not otherwise. According to others, however, 
large black ants should be applied even to the perforat- 
ed intestines in such a case and their bodies should be 
separated from their heads after they had firmly bitten 
the perforated parts with their claws. After that the 
intestines with the heads of the ants attached to them 
should be gently pushed back into the cavity and re- 
instated in their original situation therein. The bulged 
out intestines should be rinsed with grass, blood and 
dust, washed with milk and lubricated with clari- 
fied butter and gently re-introduced into the cavity of 



Chap. II.] CHIKiTSA StHANAM. ^^^ 

■ the abdomen with the hand with its finger nails cleanly 
paired. The dried intestines should be washed with milk 
and lubricated with clarified butter before introducing 
it into their former and natural place in the abdo- 
men. 39-41. 

In a case where the intestines could be but partially 
introduced, the three following measures should be 
adopted. The interior of the throat of the patient 
should be gently rubbed with a finger [and the urging 
for vomiting thus engendered, would help the full 
introduction of the intestines into the abdominal cavity]. 
As an alternative, he should be enlivened with sprays 
of cold water ; or he should be caught hold of by his 
hands and lifted up into the air with the help of strong 
attendants and shaken in a manner that would bring 
about a complete introduction of the intestines into 
the natural position in the abdominal cavity. They 
should be so introduced as to press upon their specific 
(Maladhara) Kald (facia). 42-43. 

In a case where the re-introduction of the intes- 
tines into the abdominal cavity would be found to be 
difficult owing to the narrowness or largeness of the 
orifice of the wound, it should be extended or widened 
with a small or slight incisiona ccording to requirements, 
and the intestines re-introduced into their proper place. 
The orifice or mouth of the wound should be forthwith 
carefully sutured as soon as the intestines would be 
found to have been introduced into their right place. 
Intestines dislodged from their proper seat, or not intro- 
duced into their correct position, or coiled up into a 
lump bring on death. 44-46. 

Subsequent Treatment : -[After the full 

and correct introduction of the intestines] the wound 
should be bandaged with a piece of silk-cloth saturated 

35 



274 TtiE SUSHRUTA SAMHITA. [Chap. it. 

with clarified butter, and the patient should be given a 
draught of tepid clarified butter (D. R. tepid milk) with 
castor oil for an easy passage of the stool and downward 
coursing of the Vdyu (spontaneous emission of the flatus). 
Then, for its healing up (Ropana), a medicated oil, pre- 
pared with the bark of the Asvakarnay Dhava, S'dlmali, 
Mesha'S'ringi, S'allaki^ Arjuna^ Viddri, and Kshiri trees 
and Vald roots should be applied to the wound. For a 
year the patient should live a life of strictest conticence 
and forego all kinds of physical exercise. 47 — 48. 

The legs and the eyes of the patient should be 
washed and sprinkled with water in the event of the 
bursting out of the testicles which should be intro- 
duced into their proper place within the scrotum, and 
sewn up in the manner of a Tunna-sevani (raised seam). 
The scrotum should be bandaged in the shape of a 
Grophansb-Vandha and a restraining apparatus (Ghatta- 
Yantra) placed round the waist of the patient (to 
guard it against its oscillations or hanging down). The 
wound should not be lubricated with any kind of 
oil or Ghrita inasmuch as it would make the wound 
moist and slimy. The wound should be healed with a 
medicated oil prepared with Kdldmisdri, Aguru^ Eld, 
Jdti flower, Chandana, Padmaka, Manahs'ild, Devaddru, 
Amrita and sulphate of copper (pounded together). 49-50. 

A plug of hair should be inserted into a wound on 
the head, after having extracted the foreign matter 
therefrom, with a view to arrest the exuding of the 
brain matter (Mastulunga) which invariably proves fatal 
to the patient through the aggravation of the deranged 
Vayii in consequence thereof. The hairs of the plug 
should be taken out one by one as the healing process 
progresses (granulation). An oleaginous medicated plug 
or lint should be inserted into a wound on any other 



i 



Chap. II.] CHIKITSA STHANAM. 275 

part of the body, which should be treated with the 
measures and remedial agents laid down in connection 
with a traumatic ulcer after having first allowed the 
vitiated blood to escape. 51-52. 

The medicated oil known as the Chakra-taila* 
should be poured (frequently applied) by means of a 
slender pipe into an ulcer (wound) which is deep-seated 
but narrow-mouthed, after first letting out the vitiated 
bloodf. An oil duly prepared and boiled with Samangd, 
Haridtd, Padmdy TriiargaX Tuttha, Vidanga, Katuka, 
Pathydy Guduchi and Karanja acts as a good healing 
(Ropana) agent (in these cases). The use of an oil 
prepared with Tdlis'a, Padmaka, Mdnsi, Harenu^ Aguru^ 
Chandana^ and the two kinds of Haridrd, Padma-vijuy 
Us'ira and Yashti-madhu acts as a good healing remedy 
in cases of traumatic ulcers. 53-55- 

A cut wound (Kshata) should be treated with its 
own specific measures and remedies, while a bruised 
one (Pichchita) should be treated (to all intents and 
purposes) as a case of Bhagna (bone-fracture). The first 
treatment of a mangled or contused wound (G-hrishta) 
is to extinguish pain, after which it should be dusted 
with the powder of proper medicinal drugs (such as 
S'dla, Sarja, Arjuna, etc.). 56' 57. 

In the case of a dislocation of any part of the body, 
caused by a fall (from a tree), or in the event of having 
been run over or trampled down (Mathita — by a carriage 
or by a beast), or of being wounded (by a blow, etc.), 

* The oil just pressed out of an old oil-miil or squeezed out of the 
chips of wood belonging to an old one, in the manner of the Anutaila 
to be described hereafter, is called the Ohakra-taxla 

t The vitiated blood should first be lei out for fear of putrefaction 
of the ulcer. 

:;: Triphala, Trikatu and Trimada are called Trivarga. 



276 THE SUSHRUTA SAMHITA. [Chap. II. 

the patient should be kept immersed in a large tank 
(Droni) of oil and the diet should consist of the soup or 
essence (Rasa) of meat. A man fatigued (from the 
labours of a journey), or hurt at any of the Marmas, 
should be likewise treated with the preceding 
measures. 58. 

Oil or clarified butter should be always administered 
as drinks, washes or external healing applications for an 
ulcer-patient with a due regard to his temperament and 
the nature of the season. Medicated Ghritas, yet to be 
mentioned in connection with the medical treatment of 
a Pittaja abscess, should be used as well in the case of 
a traumatic ulcer (according to its respective indica- 
tions). A physician should wash a traumatic ulcer 
attended with an aching pain either with a Vala-oil or 
tepid clarified butter (according to the nature of the 
season and the temperament of the patient).* 59 — 61. 

An oil codk^dvilthSamangd^Rajani, Padmd{fih.-krg{), 
Pathyd, sulphate of copper, Suvarchald, Pad^naka, 
Lodhra, Yashti-madhuka, Vidanga, Harenuka, Tdlisa- 
patra^ Nalada (fatdmdnsi), (red) Chandana, Padma- 
kes'ara^ Manjishthd, Usira^ Ldkshd, and the tender 
leaves of Kshiri trees, Piydla seeds, raw and tender 
Tinduka fruit, or with as many of them as would be 
available, should be regarded as a good healing remedy 
in respect of all non- malignant traumatic sores or ulcers. 
Applications of astringent, sweet, cooling and oily 
medicines should be used for a week in a case of a 
traumatic ulcer (Sadyo-vrana), after which those men- 
tioned before, in the Chapter of Divraniya, should be 
adopted. 62—63. 

* With oil in autumn and in the case of a patient of Rakta-pitta 
temperament, and wi»h Vala-oil in winter and in the case of one of a Vata- 
kapha temperament. 



Chap. II.] CHIKITSA STHANAM. 277 

Treatment of Dushta-Vrana:— In the 

case of a malignant ulcer (Dushta-Vrana) emetics, 
errhines, purgatives, Asthapana, fasting, specific sorts 
of diet (composed of bitter, pungent and astringent 
things) and blood-letting, should be prescribed (accord- 
ing to the requirements of each case). The ulcer or 
sore should be washed with the decoctions of the 
drugs of both the Aragvadhddi and the Surasddi ganas, 
and an oil cooked with a decoction of the said 
drugs should be applied to the wound for |the 
purification (Sodhana) thereof. As an alternative, an oil 
boiled and prepared in an alkaline water or solution 
(four times that of oil) with a Kalka of alkaline subs- 
tances (such as Ghantdparuli, Palas'a, etc.) should be 
used for that end. Oil cooked with Dravanti 
(Satamuli, according to certain authorities, Mushika- 
parni according to others), Chiravilva^ Dantiy Chit- 
raka, Prithvikd Nimba-leaves , Kdsisa^ Tuttha^ Trivrit, 
Tejovaii, Nili (indigo), the two kinds of Haridrd, 
Saindhava salt, Tila, Bhumi-Kadamba^ Suvahd, S'ukd- 
khyd, Ldngaldkvd, Naipdli^ Jdlini, Madayanti^ 
Mrigddani, Sudhd^ Murvd, Arka, Kitdri, Haritdla^ 
and Karanja, or with as many of them as would be 
available, should be used for the purification (of a malig- 
nant sore or ulcer). If found applicable, a medicated 
Ghrita prepared and cooked with the foregoing drugs 
and substances as Kalka should be used for the same 
purpose. In the case of a malignant ulcer, due to the 
aggravated Vayu, the purifying remedy should consist 
of a Kalka of Saindhava salt, Trivrit and castor leaves. 
In the case of a (malignant) Pittaja sore, the remedy 
should consist of a Kalka of Trivrit, Haridrd, Yashti- 
madhu and Tila. In the case of a malignant ulcer, 
caused by the aggravated Kapha, the purifying remedial 



278 THE SUSHRUTA SAMHITA. [Chap. II. 

agent should consist of Tila, Tejohvd, Danti, Svarjikd 
and Chitraka roots. An ulcer brought on owing to the 
presence of the virus of Meha or Kushtha in the system, 
measures and remedies mentioned under the treatment 
of Dushta-vrana should be adopted and used. 64 — 68. 

The recognised school of physicians, which recognises 
these six types of traumatic sores, does not add to the 
list, herein mentioned, other types of ulcers, whereas 
vain pedagogues try to swell it with a larger number of 
types by adding connotative prefixes and suffixes to the 
names of the aforesaid six. It is mere vain-gloriousness 
on their part to say so, since all the other types that 
they can devise are but single instances and can be made 
to fall under one of these six general heads. Hence 
there should be only six kinds (of traumatic sores) and 
not more. 69. 

Thus ends the second Chapter of the Chikitsita Sthanam of the Sus'ruta 
Samhita which deals with the treatment of Sadyo-vrana (traumatic sores). 



CHAPTER III. 

Now we shall discourse on the medical treatments 
of fractures and dislocations (BhagTiaS). i. 

Metrical Texts :— A fracture or dislocation 
(Bhagna) occurring in a person of a Vatika tempera- 
ment, or of intemperate habits, or in one who is sparing 
in his diet, or is affected with such supervening disorders 
(as fever, tympanites, suppression of the stool and urine, 
&c.) is hard to cure.* A fracture-patient must forego 
the use of salt, acid, pungent and alkaline substances 
and must live a life of strictest continence, avoid expo- 
sure to the sun and forego physical exercises andparchi-. 
fying (devoid of oleaginous) articles of food. A diet 
consisting of boiled rice, meat-soup, milk, f clarified 
butter, soup of Satina pulse and all other nutritive and 
constructive food and drink, should be discriminately 
given to a fracture-patient. The barks of Udumbara, 
Madhuka, As'vattha, Palds'a, Kakuhha^ Bamboo^ Vata 
or Sdla trees should be used as splints (Kusa). Manji- 
shthd, Madhuka, red sandal wood and Sdli-ricQ mixed 
with S'ata-Dhauta clarified butter (i.e., clarified butter 

* Jejjata does not read the first verse, but Gayi does. 

t As a general rule, milk should not be prescribed to a patient 
suffering from an ulcer (Vrana) in general ; but a case of fracture forms 
an exception thereto. Some authorities hold that tepid milk may be 
given to a fracture-patient, if there be no ulcer (Vrana). Others, on the 
contrary, are of opinion that milk should not, in any case, be given to a 
fracturc'patient for fear of suppuration and the setting in of pus. 

Others, however, take "Kshirasarpih" to be a compound word and 
explain the term to mean the clarified butter prepared from milk (as 
distinguished from that prepared from curd). 

But experience tells us that in cases of excessive weakness or emacia- 
tion, milk may be given without any hesitation— Ed. 



28o THE SUSHRUTA SAMHITA- [Chap. lit. 

washed one hundred times in succession) should be used 
for plastering the fracture. 2-6. 

Bandag'e : — Fractures should be (dressed and) 
bandaged once a week in cold weather, on every fifth 
day in temperate weather {i.e., in spring and autumn), 
and on every fourth day in hot weather {t.e., in summer), 
or the interval of the period for bandaging should be 
determined by the intensity of the Doshas involved in 
each individual case. An extremely loose bandage 
prevents the firm adhesion of a fractured bone, a light 
bandage gives rise to pain, swelling and suppuration 
of the local skin, &c. Hence in cases of fractures, 
experts prefer a bandage which is neither too tight nor 
too loose. 7-Z, 

Washings :— A cold decoction of the drugs of 
the Nyagrodhddi group should be used in washing (the 
affected part), whereas in the presence of (excessive) 
pain, (the part) should be washed with milk boiled with 
the drugs of the (minor) Pancha-mula, or simply with the 
oil known as the Chakra-taila made lukewarm*. Cold (or 
warm) lotions and medicinal plasters (Pradehas)ofDosha- 
subduing drugs should be prescribed with due regard to 
the nature of the season and the Doshas involved in 
each case. 9-10. 

A preparation of milk f from a cow, delivered for the 
first time, boiled with the drugs of the Madhurddi group 
and mixed with powdered shellac and clarified butter (as 
an afterthrow) should be given (when cold) to a fracture- 
patient as a beverage every morning. In a case of 

* In winter and where the aching pain is present due to Vayu and 
Kapha. 

t Consisting of the drugs of the Kakolyadi group weighing two Tolas, 
milk sixteen Tolas, water sixty-four Tolas, boiled together with the water 
entirely evaporated. 



Ghap. III.] CHIKITSA STHANAM. 2^1 

fracture attended with ulcer on the part, an astringent 
plaster plentifully mixed with honey and clarified butter 
should be applied ; and the rest (diet and regimen of 
conduct) should be as laid down in the case of a (simple) 
fracture. 11-12. 

PrOgTIO^iS : -A case of fracture occurring in a 
youth or a person with slightly deranged Doshas or in 
winter, is held to b3 easily curable (with the help of the 
aforesaid medicines and diet). A fractured bone in a 
youth is joined by the aforesaid treatment in the course 
of a month, in two months in the case of a middle- 
aged man and in three months in one of old age. 13-14. 

An elevated and fractured joint should be reduced by 
pressing it down, while one hanging down should be 
set by raising it up, by pulling it in the case of its 
being pushed aude, and by reinstating it in its upward 
(proper) position in the event of its being lowered down. 
An intelligent physician should set all dislocated (Bhagna) 
joints, whether fixed or movable, by the mode of 
reduction, known as Anchhana, Pidana, (pressure), 
Sankshepa and Vandhana (bandaging). 15-16. 

Treatment :— A crushed or dislocated joint 
should not be shaken (/.6'., should be kept at rest) and 
cold lotions or washes and medicated plasters (Pradeha) 
should be applied to the part. A joint is spontaneously 
reset to its natural or normal state or position after the 
correction of its deformity incidental to a blow or hurt 
having been effected. The fractured or dislocated part 
should be first covered with a piece of linen soaked in 
clarified butter. Splint should then be placed over it 
and the part properly bandaged. 17-19. 

Treatment of fractures in particular 

limbs : — Now we shall discourse on the measures to 
be adopted in fractures occurring in each particular 

36 



282 THE SUSHRUTA SAMHITA. [Chap. HI. 

limb. In the case of a nail-joint, being in any way- 
crushed or swollen by the accumulation of the deranged 
blood (in the locality), the incarcerated blood should be 
first let out with the help of an awl (Ard) and the part 
should be plastered with a paste of S^li-rice. A finger or 
phalanx bone put out of joint or fractured should be first 
set in its natural position and bandaged with a piece of 
thin linen and should be then sprinkled over with 
clarified butter. In the case of a fracture in the foot the 
fractured part should be first lubricated with clarified 
butter, then duly splinted up, and bandaged with linen. 
Such a patient should forego all kinds of locomotion. 
In the case of a fracture of the knee-joint or thigh-bone 
the affected part should be lubricated with clarified 
butter and carefully pulled straight, after which it should 
be splinted with barks (of Nyagrodha, etc.) and band- 
aged with clean linen. In case of the fracture projecting 
out a thigh-bone should be reset with the help of a 
circular splint and bandaged. In the case of Sphutita 
(cracked) or Pichchita (bruised) thigh-bone, the part 
should be also bandaged in the aforesaid manner. 20-24. 
In a case of a fracture in the Kati (Ilium-bone), it 
should be reduced by the fractured bone being raised 
up or pressed down (as the case may be) and the patient 
should then be treated with Vasti (enematas of medicated 
oils or Ghritas*;. In the case of a fracture of one 
of the rib-bones (Parsaka), the patient should be lubri- 
cated with clarified butter. He should then be lifted 
up (in a standing posture) and the fractured rib (bone), 
whether left or right, should be relaxed by being rubbed 
with clarified butter. Strips of bamboo or pad 

* In the Niddna-Sthana—Chap. XV., 9— it is stated that a case of 
fracture in the Kati should be given up (Varjjayet). Jejjata, however, 
explains "Varjjayel" as "hard to cure." 



Chap. III.] CHIKITSA STHANAM. 283 

(Kavalikaj should b3 placed over it and the patient 
should be carefully laid in a tank or cauldron full of 
oil with the bamboo splint duly tied up with straps 
of hide. In the case of a dislocation of the Amsa- 
Sandhi (shoulder-joint), the region of the Kaksha 
(arm-pit) should be raised up with an iron-rod (Mushala) 
and the wise physician should bandage the part, thus 
reduced, in the shape of a Svastika (8-shaped) bandage. 
A dislocated elbow-joint should be first rubbed with 
the thumb, after which it should be pressed with a view 
to set it in its right place by fixing and expanding the 
same. After that the affected part should be sprinkled 
over with any oleaginous substance. The same measures 
should be adopted in the case of a dislocation of 
the knee-joint (Janu-sandhi), the wrist-joint (Gulpha- 
sandhi) and the ankle-joint (Mani-vandha). 25-29. 

In the case of fractured bones in the palms of the 
hands, the two palms* should be made even and opposed, 
and then bandaged together and the affected parts should 
be sprinkled with raw and unmedicated oil (Ama-taila). 
The patient should be made later first to hold a ball of 
cow-dung, then a ball of clay and then a piece of stone 
in his palms and so on, with the progressive return of 
strength (to the affected parts). In a case of a fracture of 
the Akshaka, the affected part should be first fomented 
and then reduced by raising it up with a Mushala 
(iron-rod) in the arm-pit or by pressing it down (as the 
case may be) and should be firmly bandaged. A case 
of fractured arm-bone should be treated according 
to the directions given in the case of a fractured 
thigh-bone. 30-32. 

* The text has ''Ubhe tale same kritvd.'' Jejjata explains "Ubhe tale" 
to mean "palms of the hands and soles of the feet j" Gaya Dasa explains 
it to mean "the palms of both the bands." 



284 THE SUSHRUTA SAMHITA. [Chap. HE. 

Iiith3cas3of a banding (twisting) or intussuscep- 
tion of the neck downward, the head should be lifted up 
by putting the fingers into the hollow (Avatu) above the 
nape of the neck and at the roots of the jaw-bones (Hanu;*. 
Then the part should be bandaged with a piece of linen 
after having evenly put the splint (Kusa round the neck). 
The patient should be caused to lie constantly on his 
back for a week. In a case of a dislocation of the joints 
of the jaw-bones (Hanu\ the jaw-bones should be foment- 
ed and duly set in their right position, bandaged in the 
manner of a Panchangi-vandha, and a Ghrita boiled 
and prepared with (the Kalka and a decoction of) the 
Madhura (Kdkolyadi) and Vdyu-subduing (Chavy^di) 
groups should be used as errhines by the patient. 33-3 ^ 
A tooth of a young person, not broken but loose, 
should be plastered with a cooling paste on its outside 
after having pressed out the accumulated blood at the 
root. The tooth should be sprinkled or washed with 
cold water and treated with drugs having Sandhdniya 
(adhesive) properties f The patient should be caused 
to drink milk with the help of a lotus stem. The 
loose tooth of an old man should be drawn. A nose 
sunk down or depressed (by a blow) should be raised 
up with the help of a rod or director, while it should 
be straightened in a case of simple bending. Then 
two tubes, open at both ends, should be inserted into 
the nostrils (to facilitate the process of breathing) 
and the organ should be bandaged and sprinkled with 
clarified butter. In the case of (the cartilage of) the 
ear being broken, the organ should be rubbed with 

* According to Gayi, the lifting up of the head by putting fingers in 
ihe Avatu and in the Hanus should be made in cases of bending and 
intussusception of the neck respectively. 

t Honey, clarified butter, and drugs of the Nyagrodhddi group. 



Chap. III.] CHTKITSA STIIANAM, 285 

clarified butter straightened, and evenly set in its 
right position and bandaged. Measures and remedial 
agents mentioned in connection with Sadyo-vrana, 
should be likewise adopted and employed in the present 
instance. 37. 

In a case of a fracture of the bone of the forehead 
unattended by any oozing out of brain matter, the 
affected part should be simply rubbed with honey and 
clarified butter and then duly bandaged. The patient 
should take clarified butter for a week * 38. 

Cooling plasters and washes should be applied to a 
part of the body, swollen but not in any way ulcerated 
on account of a fall or a blow. In the case of a fracture 
of the bone in the leg and in the thigh, the patient should 
be laid down on a plank or board and bound to five 
stakes or pegs in five different places for the purpose 
of preventing any movements of his limbs. The 
distribution of the (bindings) pegs in each case should be 
as follows. In the first case (fractured leg-bone), two on 
each side of the two thighs making four and one on the 
exterior side of the enguinal region of the affected side. 
In the second case (fracture of knee-joint) two on each 
side of the ankle-joints making four and one on the side 
of the sole of the affected leg. The same sort of bed and 
fastenings should be used in cases of fractures and 
dislocations of the pelvic-joint, the spinal colnma, the 
chest and the shouldersf. In cases of long-standing 
dislocations, the joint should be lubricated with oily or 
lardaceous applications, fomented and softened (with 

* In the case of such an emission or oozing out a plug of bristles or 
hiir as described in the preceding chapter and remedial agents laid down 
in conneclion therewith, should be used. 

t The principle of splintering and bandaging may be profitably 
compared with those followed in Agnur's splint. 



286 THE SUSHRUTA SAMHITA. [Chap. III. 

proper medicinal drugs) in the manner mentioned above 
in order to reduce it to its natural state. 39-40. 

In the case of a faulty union of a (fractured) bone 
lying between two joints (Ka^ada-bhagna^, the union 
should be again disjointed, and the fractured bone should 
again be set right and treated as a case of ordinary 
fracture. In the case where a fractured bone would be 
found to have protruded out of the ulcerated part and 
dried, it should be carefully cut off near the margin of 
the (incidental) ulcer, (so as not to create a fresh ulcer on 
any other spot of the affected part) and subsequently 
treated as a case of fractural ulcer. A fracture occurring 
in the upper part of the body should be treated with 
applications of Mastikya-Sirovasti [oil-soaked pads on 
the head] and pourings of oil into the cavity of the ears. 
Potions of clarified butter,* errhines and Anuvasana 
(enematas) should be prescribed in cases of fractures in 
the extremeties. 41-43. 

Gandha'-Taila ;— Now we shall discourse on 
the recipe of a medicated oil, capable of bringing 
about the union of fractured bones. A quantity of black 
sesamum-seeds (tied up into a knot with a piece of linen) 
should be kept immersed at night in a stream of running 
water and taken out and dried in the sun (for seven conse- 
cutive days). It should then be saturated with cow's milk 
(at night and dried in the sun, during the second week). 
During the third week the sesamum-seeds should be 
saturated with a decoction of Yashti-madhu (at night) 
and dried in the sun the next day. Then (during 
the fourth week) it should be again saturated with cow's 
milk and dried and powdered. The said sesamum- 

* According to Jejjata, not. only Anuvds;ina-enematas but potions of 
clarified butter and errhines also should be prescribed in cases of fractures 
in the extremeties* 



Chap. Hi.] CHIKITSA STHANAM. 287 

powder and powder of the drugs, constituting the 
Kdkolyddi Gana as well as Yasthi-madhu^ Manjishthd, 
Sdrivd, Kushtha, Sarja-rasa^ Mdnsi, Deva-ddru, (red) 
Chandana^ and S'atapushpd should be mixed together. 
Then a quantity of cow's milk boiled with the aromatic 
drugs (of the Eladi group) should be used with the pre- 
ceding pulverised compound for the purpose of pressing 
out the oil therefrom. The oil thus pressed out" should 
be boiled in four times the quantity of cow's milk with 
the drugs such as Eld^ S'dlparni, Tejapatra, Jivaka, 
Tagara, Rodhra^ Prapaundarika^ Kdldnusdri, (Tagara), 
Saireyaka, Kshira-Viddri, Anantd, Madhulikd, S'ringd- 
taka^ and those of the aforesaid list (Kdkolyddi group 
and Yasthi-madhu^ etc., up to S'atapushpd) pasted 
together. The oil should be duly cooked over a 
gentle fire and is called the Gandha-Taila. This oil 
should be administered with good results in possible 
ways (e.g., as potions, liniments, unguents and errhines) 
to a fracture-patient. Its efficacy is witnessed in cases 
of convulsions, hemiplegia, parchedness or atrophy of 
the palate, in Ardita (facial paralysis) as well as in 
Manyd-stambha (Paralysis or stiffness of the neck), 
in diseases of the head (cephalagia), in ear-ache in 
Hanu-graha, in deafness and in blindness and in 
emaciation due to sexual excesses. Administered in 
food or drink, or employed as a liniment, in Vasti-karma 
(enemata measures) or as an errhine, it acts as a 
sovereign restorative. Rubbed over the neck, chest 
and shoulders, it adds to the strength and expansion 
of those parts of the body, makes the face fair and 
lovely like a full-blown lotus and imparts a sweet 

* There should be three parts of sesamum powder and one part of 
the powders of Kakolyadi, Yashti-madhu, ManjUhthd, etc. (combined). 
But siva Dksa says that four parts of sesamum-powders should be taken. 



288 THE SUSHRUTA SAMHITA. [Chap. III. 

fragrance to the breath. It is one of the most powerful 
Remedial agents in disorders of the aggravated V^yu 
(diseases of the nervous system). It may be used 
even by kings and for them it should be specially 
prepared. 44-45. 

The expressed oil of the seeds of the Trapusha, 
Aksha and Piydla should be cooked with a decoction of 
drugs of the Madhura group (Kakolyadi gana) and with 
ten times the quantity of milk. A quantity of lard if 
available, should be poured into it (during the process of 
cooking). It is an excellent medicated oil and used as 
a potion for anointing, and as an errhine, Vasti-karma 
and washes, it speedily brings about the union of 
fractured bones. 46. 

A physician should exert his utmost to guard against 
the advent of any suppurative setting in in a fractured 
bone, since a suppuration of the local veins, nerves and 
muscles is difficult to cure. A complete union of a 
fractured joint should be inferred from its painless or 
unhurt character, from its full and perfect development 
(leaving no detectable signs of its once fractured con- 
dition)j from the absence of all elevation (unevenness) 
and from its perfect freedom in flexion and expansion, 
etc. 47-48. 

Thus ends the third Chapter of the Chikitsita Sihanani in the Sua'ruta 
Sanihila which deals with the medical treatment of fractures and dis- 
locations. 



CHAPTER IV. 

Now we shall discourse on the medical treatment of 
nervous disorders (Vata-vyadhi). i. 

IVIetrical Texts ; — The patient having been 
made to vomit in the event of the deranged Vayu being 
incarcerated (lodged) in the Amais'aya (stomach), a 
pulverised compound known as the Shad-Dharana-yoga 
(a compound of six Dharanas or twenty-four Mash^ 
weight) with tepid water should be administered to him 
for seven days. A compound made up of Chitraka, 
Indra-yava^ Pdthd, Katuka^ Ativishd, Abhayd (taken 
in equal parts) together is known as the Shad- 
Dharana-yoga* and contains the properties of sub- 
duing an attack of Vdta-vyadhi. 2-3. 

In the event of the aggravated Va} u being incar- 
cerated in the Pakvsts'aya intestines), purgatives of fatty 
matters (Sneha-Virechana, i.e ,Tilvaka-Sarpih,ctc.), and 
Sodhana- Vasti of purifying drugs (with decoctions and 
Kalka of fatty matters) and diet (Pras'a) abounding in 
saltf or saline articles should be prescribed. In the case 
of the aggravated Vayu being incarcerated in the Vasti 
(urinary bladder), diuretic (lit. bladder-cleansing) 
measures and remedial agents should be resorted to. 
Anointing with medicated oils, Ghritas, etc., application 
of poultices (Upanaha) compounded of Vayu-subduing 
drugs, massage, and plasters (Alepa) of similar pro- 
perties are the remedies in cases where the aggravated 
Vayu is lodged in the internal ducts or channels such 

* One Dharana is equal to four Mashas. 
I Sneha-Lavana and Kanda-Lavana, etc. 

17 



290 THE SUSHRUTA SAMHITA. [Chap. iV. 

as the ears, etc, of the body. Blood-letting (vene- 
section) is the rem edy where the aggravated Vayu 
would be found to be confined in the skin, flesh, 
blood or veins (Sirds). Similarly, application of fatty 
matters (Sneha), actual cauterization, massage, appli- 
cation of poultices and binding of ligatures should be the 
remedies where the aggravated Vayu would be found 
to have become involved in the Siia(yu (ligaments), joints 
and boaes Where the aggravated Vayu would be 
found to have become situated in the bone, the skin and 
flesh of that part of the body should be perforated with 
a proper surgical instrument (Ara-Sastra) and the under- 
lying bone should be similarly treated with an awl. A 
tube open at both ends should be inserted into the 
aperture, thus made, and a strong physician should suck 
the aggravated Vayu from out of the affected bone by 
applying his mouth to the exteiior open end of the 
tube. 4-9. 

In the case of the aggravatd V^yu having contamin- 
ated the semen, measures and remedies for seminal dis- 
orders (Sukra-doshai* should be employed. The intelligent 
(physician) would take recourse to measures, such as 
blood-letting, immersion or bath in a vessel (full of Vayu- 
subduing decoctions), fomentation with heated stones, as 
well as in the manner of Karshu-Sveda, vapour-bath in 
a closed chamber (Kuti sveda), anointment, Vasti- 
Karmas, etc., in the event of the aggravated Vayu having 
extended throughout the whole organism ; whereas 
bleeding by means of a horn (cuffing) should be 
regarded as the remedy when the aggravated Dosha 

* Treatmenls, such as, the purification of the semen, etc., and the use 
of medicin s for making Aphrodisia (Vaji-karana) and for the remedy 
of the disordered urinary organ (Mutra-dosha) should be adopted and 
employed. 



Chap. IV.] CHIKITSA STHANAM. 291 

would be found to have been confined in any parti ular 
part of the body* 10-12. 

In the event of the aggravated Vayu being connected 
either with the Pitta or the Kapha, such a course of treat- 
ment should be adopted as would not be hostile to the 
two other Doshas. Blood-letting (in small quantities) 
should be resorted to several times in a case of 
complete senesthesia (Supta-Vata) and the body should 
be anointed with oil mixed with salt and chamber-dust 
(Agcira-dhuma) Milk bailed with a decoction of the 
drugs of the Pancha-mula group, acid-fruits (Phalamla), 
meat-soup or soup of (well-cooked) corn (Dhanya) 
with clarified butter are beneficial in cases of Vata- 
roga. 13-15. 

^alvana-Upanaha :-A poultice composed 

of the drugs of the Kdkolyadi group, the Vayu-sub- 
duing drugs (those of Bhadra-ddrvddi and Vidari- 
gandhadi groups), and all kinds of acid articlesf (such as, 
Kanjika, Sauvira, fermented rice-gruel, etc.), the flesh of 
animals which live in swamps (Anupa) or in water 
(Audaka)l, oil, clarified butter and all kinds of 
lardaceous substances, mixed together and saturated 
with a profuse quantity of salt and then slightly heated 
is known by the name of Salvana A person suffering 
from any form of Vata roga should be always treated 
with such Salvana poultices (Upanaha). The poultice 
should be applied to such part of the body as is 

* It is to be understood that measures and remedies laid do^vn 
under the head of Sarvanga-gata should be used when the Vayu 
would be found to be diffused throughout the whole organism instead of 
being confined to any specific pari. 

t According to others it means all kinds of acid- fruits, etc. 

t Chakradatla reads "^CT^^flt^l ^rf^S:" (well-cooked with the flj.h 
of "Anupa" animals) in place of ^l'Tqt^8Rl^t€'^ I 



292 TJ'E SUSHRUTA SAMHITA. [Chap. IV. 

numbed, painful or contracted and the affected part 
should be fiimly bandaged thereafter with a piece of 
Kshauma* linen ( r woollen cloth. As an alternative, 
the affected part should be plastered (and well rubbed) 
with the ingredients of the Salvana-Upanaha and inserted 
into a bag made of cat or mungoose skin or that of a 
camel or deer hide. i6. 

The aggravated Vayu, if located in the shoulders, the 
chest, the sacrum i^Trika) or the Manya, should be subdued 
by emetics and errhines judiciously employed. Siro-Vasti 
should be applied to the head of the patient as long as it 
would take one to utter a thousand Matras (a short vowel 
sound), more or less, as the case may require, where the 
aggravated Vayu would be found to have located itsellf 
in the head, (if necessary) blood-letting should be 
resorted to. As a mountain is capable of obstructing the 
passage of the wind, so the Sneha-Vasti (oily enema) is 
alone capable of resisting the action of the aggravated 
Vayu whether it extends throughout the whole system 
or is confined to a single part. 17-19 

Measures beneficial to Vata-Vyadhi: 

— An app'.ication of Sneha, fomentations, anointment of 
the body, Vasti, oily purgatives, Siro-vasti, the rubbing of 
oils on the head, oily fumigation, gargling with tepid oil, 
oily errhines, the use of meat-soup, milk, meat, clarified 
butter, oil and other lardaceous articles (of food), all 
kinds of acid fruits, salt, lukewarm washes, gentle 
massage, the use of saffron, Agura^ Patra^ Kushtha, Eld^ 
Tagara, the wearing of woollen, silken, cotton or any 
other thick kind of garments, living in a warm room or 
in one not exposed to the wind or in an inner chamber, 
the use of a soft bed, basking in the glare of fire, entire 
sexual abstinence, these and such like other things 

* Some lead it as Valka, i.e.^ made up bark. 



Chap. IV ] CHIKITSA STHANAM. 293 

should be generally adopted by a patient suffering from 
Vata-roga 20. 

The Tilvaka-Ghrita :— A paste (Kalka) of 

the following drugs, viz, Trivrit, Danti, Suvarna-kshiri, 
Saptald, S amkhini^ Triphald and Vidariga, each weigh- 
ing an Aksha vtwo tolas\ and Tilvaka- roots and 
Kmnpillaka^ each weighing a Vilva (eight tolas), a 
decoction of Triphala and curd, each weighing two 
Patras '■'' ^^thirty-two seers) and clarified butter, weighing 
sixteen seers, should be duly cooked together. Medical 
authorities recommend this Tilvaka Ghiila as an oily 
purgative in cases of Vata-roga. As'oka-Ghrita and 
Ramyaka-Ghrita aie prepared in the same manner, (viz., 
by substituting As'oka and Ramyaka respectively for 
Tilvaka). 21. 

The Anu-Taila:— The log of a long-standing 
wooden oil-mill should be cut into small chips and then 
thrashed and boiled in water in a large cauldron. The 
globules of oil that will be found floating on the surface 
of the boiling water should be .'^kimmed off either with 
the hand or with a saucer. The oil thus collected 
should then be cooked with the Kalka of Vayu-subduing 
drugs as in the preparation of a medicated oil. This 
oil is known as the Anu-Taila- The use of this oil has 
been advised by medical authorities in cases of Vdta- 
roga. This oil is so named from the fact of its being 
pressed out of small chips of oily wood (as described 
above). 22. 

The Sahasra-paka-Taila :-The wood 

of drugs belonging to the group of Maha-pancha-mula 
should be collected in large quantities and burnt on a 

* Palra means 64 Palas, i e., 8 Seers, but in cases of liquids the 
weight should be doubled, 



294 THE SUSHRUTA SAMIIITA. [Chap IV. 

plot of land, so as to make the soil black. The fire 
should be kept buniing one whole night ; on the 
following morning on the extinction of the fire the ashes 
should be removed and the ground, when cool, should 
be soaked with one hundred Ghatas (six thousand and 
four hundred seers) of oil cooked with the drugs of 
the V id di'i-gandh a di gj'oup d^nd with, the same quantity 
of milk and kept in that condition for one night more. 
On the next morning the earth should be dug up, down 
to the stratum found to have been soaked with the oil 
and the soil should then be dissolved in warm water in 
large cauldrons for the purpose. The oil that will be 
found floating on the surface of the water should be 
skimmed off with both hands and kept in a safe basin. 
Then the decoction of the Vayu-subduing drugs (the 
Bhadra-darvadi group), meat-juice, milk, fermented rice- 
gruel (each taken in a quantity measuring a quarter 
part of that oil) should be taken one thousand times 
and each time should be boiled with the oil. Vayu- 
subduing and aromatic drugs and spices, in the northern 
(^trans-Himalaya) and southern (Deccan) countries, should 
be thrown into it and boiled with the oil. The boiling 
should be completed within the period during which it 
could be properly done. Then after the completion of 
tne cooking, conch-shells should be blown, Dundubhis 
should be sounded, umbrellas should be held open, 
ehowries should be blown into it and a thousand 
Brahmins should be treated with repasts. The oil so 
sacredly prepared should be stored carefully in golden, 
silver or earthen pitchers. This oil is called the 
Sahasrapatka-Taila and is of irresistible potency and 
fit even for the use of kings. Satapa(ka-Taila is also 
prepared in the above manner (with the aforesaid ingre- 
dients) by cooking it one hundred times only. 23. 



chap. IV.] CHIKITSA STHANAM. 295 

The Patra-Lavana :— The green leaves of the 
Eranda plants and those of the trees known as Mush- 
kaka, Naktamdla, Atarushaka, Piiiika, Aragvadha and 
Chitraka should be thrashed with (salt of equal quantity) 
in an Udukhala (a hand thrashing mill) and placed in 
an earthen pitcher, saturated with oil or clarified butter. 
Having covered the mouth of the pitcher with a lid, it 
should be plastered and burnt in fire of cow-dung. 
The medicine thus prepared t^with the help of internal 
heat) is called the Patra-Lavana. Medical experts 
advise the application of this medicine in cases of 
Vata-roga. '^4. 

The Kanda-Lavana ".—Similarly, Snuhi- 
twigs, Brinjal (Vdrtdku), and 5' 4'"'''^- bark (taken in 
equal parts) and rock-salt (of equal weight as the entire 
drugs) should be thrashed and kept in a pitcher. Oil, 
clarified butter, lard and marrow should be added to 
it equal in weight with salt and then having covered 
the mouth of the pitcher with a lid, it should be plaster- 
ed and burnt in a fire of cow-dung (as before). The 
use of this medicated salt which is called the Kanda- 
Lavana or Sneha-Lavana is recommended by experts 
in Vata-roga. 25. 

The Kalyanaka-Lavana :— The follow- 
ing drugs with their roots, leaves and twigs, viz,, 
Gandira^ Paldsa, Kutaja, Vilva, Arka, Snuhi, Apd- 
indrga, Pdtald, P dribhadra^ Nddeyt, Krishnagandhd 
Nipa, Nimba, Nirdahani, Atarushaka, Nakta-mdlaka, 
Putika, Vfihati, Kantikari, Bhalldtaka, Ingudi, Baija- 
yanti, Kadali, Varshdbhu, Hrivera^ Kshuraka, Indra- 
vdruni, S vet amoks haka and Asoka should be gathered in 
a green condition and mixed with (as large a quantity 
of) rock-salt and having thrashed them in an Udukhala 
should be burnt in a hermetically sealed pitcher as 



tg6 THE SUSHRUTA SAMIIITA. [Chap. iV. 

above, after which it should be filtered (twenty times) 
and boiled in the manner of alkaline preparations At 
the close of the boiling, powders* of the drugs of the 
Hingvddi or Pippalyadi group should be mixed with 
it. This medicine is called the Kalsiynaka-Lavana and 
is specially efficacious in all cases of Vata-roga and 
is applicable both in food and drink in cases of Gulma, 
enlarged spleen, impaired digestion, indigestion, hae- 
morrhoids, intestinal worms, aversion to food and 
cough. 26 . 

IVIemorable Verse :— The remedy proves 
efficacious in Vata-roga through its heat-making potency, 
power of liquifying and secreting the deranged Doshas 
and of restoring and correcting them as well. 27, 

Thus ends the fourlh Chapter of the Chikitsila Sthanam in the 
Sus'ruta Samhita which deals with the treatment of Vata-\ yadhi. 

* The total weight of these powders should be one-fourth of the 
weight of the rock-salt taken in ihe course of the preparation.— Ddllana. 



I 



K 



CHAPTER Y. 

Now we shall discourse on the chapter which deals 
with the medical treatment of IVIaha-V^ta- 

Vyadhi. i. 

Several authorities group the disease Vata-Rakta 
under two different sub-heads, such as superficial and 
deep-seated. But such a classification is arbitrary and 
unscientific, inasmuch as this disease first manifests 
itself on the surface (layer of the skin) like Kushtha and 
gradually invades the deeper tissues of the body. Hence 
there are no (two) forms of this disease. i-2. 

Causes of V^ta-Rakta :— The Vayu of 

the body is enraged or agitated by such causes as 
wrestling with a man of superior and uncommon physical 
strength, etc., while the blood is vitiated by such causes 
as constant over-eating of edibles which are of difficult 
digestion and heat-making in their potency or ingestion 
of food before the digestion of the previous meal. The 
Vayu thus enraged and agitated enters into the blood- 
carrying channels of the body and being obstructed 
in its passage, becomes mixed with the vitiated blood. 
The deranged Vayu and the blood thus combine to give 
rise to a disease characterised by the specific symptoms 
of each, which is known as Vaita-Rakta. The charac- 
teristic pain, which at first confines itself to the extre- 
mities, gradually extends over the whole body. 

Premonitory symptoms of Vstta- 

Rakta : —The disease is ushered in with a pricking 
pain, a burning and an itching sensation (in the affected 
part), a swelling, roughness and numbness (anaesthesia) 
of the diseased locality, throbbing of the veins, ligaments, 

38 



^9^ tHE SUSHRUTA SAMHITA. [Chap. V. 

nerves and arteries, a weakness in the thighs and sudden 
appearance of red or brownish circular patches on the 
palms of the hands and soles of the feet, fingers and heels, 
etc., (A. R. — wrists). If neglected and immoderately 
treated in its premonitory stages, the disease soon 
develops its characteristic symptoms in succession, which 
have been described before ; whereas (a lifelong) defor- 
mity (of the affected part) is the penalty for neglecting 
it (in its fully patent or developed stage). 3. 

Memorable Verse : — Men of a mild and deli- 
cate constitution, as well as those who are (inordinately) 
stout or sedentary in their habits or are addicted to 
unwholesome and incompatible food, etc., are generally 
found to be susceptible to an attack of Vaita-Rakta. 4. 

PrOgTIOSiS : — A physician is advised to take in 
hand the medical treatment of a Vata-Rakta-patient 
who has as yet not lost much strength and muscle, nor is 
afflicted with thirst, fever, epileptic fits, dyspnoea, cough, 
numbness (of the affected part), aversion to food, indi- 
gestion, extension and contraction of the limb, as well 
as of a person who is strong and temperate in his living 
and can afford to pay for the diet and other necessary 
accessories of the treatement. 5. 

Preliminary remedial measures :— in 

the first stage of the disease the blood, having become 
vitiated owing to its being obstructed in its course (by 
the unusually agitated Vayu in the system), should be 
gradually and not profusely bled, except when the body 
would be found to have become extremely dry or to have 
lost its natural healthful glow or complexion through the 
action of the aggravated morbific principle (Vdyu), for 
fear of further aggravating the Vayu. Emetics, purga- 
tives, and Vasti (enemas), etc., should be administered 
and the patient should be made to take a diet consisting 



Chap, v.] CHIKITSA STHANAM. 299 

of old and matured clarified butter (and boiled rice), in 
the case where the aggravated condition of the deranged 
Vayu would be found to predominate. As an alternative, 
he should be made to drink a potion consisting of goat's 
milk mixed with half its quantity of oil, with two Tola 
weight of Yashti-madhu or goat's milk cooked with 
Pris'niparni (two Tola weight) with honey and sugar 
(added after cooking), or cooked with S'unthi, S'ringd- 
taka, and Kas'eruka, or cooked with Syamd, Rdsnd, 
Sushavi, Pris'niparni^ Pilu, S'atdvari, S'vadojnshtrd and 
Das'a-fmda. 6 

Oil, cooked with the addition ol milk previously 
boiled with the decoction of Das'a-mula of eight times 
its own weight and a Kalka of Madhuka, Mesha-s'ringi 
(A. R. Sarngashta), S'vadmnshtrd, Sarala, Bhadra-ddru^ 
Vachd and Surabhi pasted together, should be adminis- 
tered in drinks, etc , (viz , anointment, sprinkling, etc.\ 
As an alternative, the oil cooked with the decoction of 
S'atdvari, Mayuraka, Madhuka, Kshira-Viddri^ Vald, 
Ati-vald and Trina-pancha-mula . with the paste of the 
drugs belonging to the Kdkolyddi group, or the oil^^ 
cooked with the decoction and a Kalka of Vala for 
a hundred times should be prescribed for the patient. 
The affected part should be washed with the milk, boiled 
with the roots of the Vata-hara (Vayu-subduing) drugs 
(?>., Das'a-mula), or simply with Amla (gruel, etc.), or 
a plaster composed of barley, Madhuka, Eranda (castor) 
and Varshdbhu (pasted together and heated), should be 
applied to the part. 7. 

Plasters, etc. : — Barley, wheat, sesamum, 
Mudga pulse aud Masha pulse should be taken in equal 

* According to Jejjata Acharyya, the *' Vala-Taila", which is 
administered in the medical treatment of Mudha-garbha, should be 
prescribed in this case. 



300 THE SUSHRUTA SAMHITA. [Chap. V. 

parts and pounded separately ; and the paste of the 
following drugs, viz., Kdkoli, Kshira-kdkoli, /ivaka, 
RishabhakUy Vald, Ati-vald^ Visa-mrindla (lotus stem), 
Pris'niparni, Mesha-s'ringi, Piydla^ S'arkard (sugar), 
Kas'eruka, Surabhi, and Vachd should be mixed with 
each of the preceding powders and each of these 
compounds (so formed) should be boiled with milk, 
oil, lard, marrow and clarified butter. The five 
compounds, thus prepared, are called Pa^yasas, which 
should be applied as a hot poultice (Upandha) to 
the affected part ; or an Utkarikgk, made of the pulp 
of oily fruit (seeds) * (prepared by cooking them with 
milk) should be applied ; or powders of wheat, barley, 
sesamum, Mudga pulse, or Masha pulse, and Vesavdra, 
made of various kinds of fish and flesh, should be used 
as a plaster. Vilvapes'ikd, Tagara, Deva-ddru, Sarald^ 
Rdsnd, Harenu, Kushtha, S'ata-pushpd, Eld, Surd and 
cream of milk-curd pasted together, should be applied 
to the affected part as a plaster (UpanaLha'. As an 
alternative, the expressed juice of Matulunga, mixed with 
Kanjika, Saindhava salt and clarified butter, pasted to- 
gether with the root of the Madhu-s'igru and with sesa- 
mum,-]- should be used in a similar way. The preceding 
remedies should be administered in a case of Vaita-Rakta 
maiked by a preponderance of the aggravated Vayu. 8. 

Vata-Rakta with a preponderance 

of Pitta : — In cases of Vdta-Rakta where the Pitta 
preponderates, the patient should be made to drink a 
potion consisting of a decoction of Drdkshd, Aragvadha^ 
Katphala, Kshira-viddri, Yashti-madhu, Chandana and 
Kds w^r^'<3! sweetened with a quantity of sugar and honey. 

* Such as sesamum, castor-seed, linseed, Vibhitaka-seeds, etc. 
t Some say that a paste of sesamum only should be used as a 
i separate plaster. 



Chap, v.] CHIKITSA STHANAM. 3OI 

As an alternative, a decoction of S'atdvari, Yashti- 
madhu, Patola, Triphald, and Katu-rohini^ or a decoction 
of Guduchi^ or a decoction of the drugs belonging to the 
Chandanadi group, which are possessed of virtues for 
allaying pittaja fever, should be administered to the 
patient, sweetened with sugar and honey. Clarified 
butter, cooked and prepared with a decoction of bitter 
and astringent drugs* also proves beneficial in such 
cases. 9. 

The affected part should be washed (Parisheka) with 
a decoction of Visa-mrindla, Chandana and Pad?naka 
(taken in equal parts and) mixed with half its quantity 
of milk. As an alternative, the affected part should be 
sprinkled with a compound composed of milk, the 
expressed juice of Ikshu (sugar-cane), honey, sugar, and 
washings of rice (taken in equal parts) ; or with curd- 
cream, honey, and Dhanydmla (fermented paddy-gruel), 
mixed with a decoction of grapes and Ikshu ; or the 
affected part should be anointed with clarified butter 
cooked with the drugs of the Jivaniya group, or with the 
clarified butter washed a hundred times in water, or 
with clarified butter cooked with the Kalka of the 
Kdkolyddi group. 10. 

Pradeha (plaster) composed of S'dli, Shashtika, Nala^ 
Vanjula, Tdlis'a, S'rigdtaka^ Galodya, Haridrd, Gairika^ 
S'aivala, Padma-kashtha, leaves of padma (lotus), pasted 
with Dhdnydmla and mixed with clarified butter, should 
be applied to the affected part. This plaster (Pradeha) 
may be applied lukewarm even in cases of Vdta-Rakta, 
marked by a preponderance of the aggravated Vayu. 
All the remedial measures (laid down above) may also 

* D. R.— Sweet, bitter, and astringent drugs. 

Bitter drugs— Patoladi group ; Kashdya drugs— Triphaladi group ; 
sweet drugs— Kakolyadi group. 



302 THE SUSHRUTA SAMHITA. [Chap. V. 

be advantageously applied in cases marked by a pre- 
ponderance of the vitiated blood, with this exception 
that cold plasters and repeated blood-lettings should 
be resorted to in the- latter (Raktaja-Vata-Rakta). ii. 

Vata-Rakta with a preponderance 

of Kapha:— Incases where the Kapha preponderates, 
the patient should be made to drink a potion consisting 
of a decoction of Haridrd and Amalaka, sweetened with 
honey ; or a decoction of Triphald, or a Kalka of 
Madhuka, S'ringavera, Haritaki -ax^A Tikta-rohini m.x'K.Q.d 
with honey. As an alternative, Haritaki and treacle 
with either cow's urine or water, should be given to him. 
The affected part or limb should be sprinkled or 
washed with cow's urine, oil, alkaline water, Sura, Sukta, 
or with a decoction of Kapha-destroying drugs. A hot 
decoction of the drugs constituting the Aragvadhadi 
group may be used with benefit in sprinkling the 
affected part. The body of the patient should be lubri- 
cated or anointed with clarified butter, boiled with 
the cream of milk-curd, cow's urine, wine, S'ukta'd.nA 
with the Kalka of Yashti-madhu, Sdrivd and Padma- 
kdshtha. A plaster (Pradeha), composed of pounded 
sesamum, mustard seed, linseed and barley (taken jn 
equal parts) and mixed and pasted with S'leshmdtaka, 
Kapittka,Madhu-s'{grudLXid.covj's urine, and Yava-kshdra 
should be applied (hot to the seat of the disease). 12-13. 

The Five Pradehas :--(i)Apaste of white 

mustard seed, (2, that of sesamum and As'vagandha, 

(3) a similar paste of Piydla, S'elu and Kapittha bark, 

(4) that of Madhu-ii'gxw, Punarnavd and (5^ a paste of 
Vyosha, Tiktd, Prithakparni and VriJiati, these five 
kinds of Pradehas should be separately pasted with 
alkaline water and (any of them) applied lukewarm to 
the affected locality. 14. 



Chap, v.] CIIIKITSA STHANAM. 303 

As an alternative, a plaster composed S'dlaparni, 
Pris'niparni, Vrihati and Kantakdri, pasted together 
with milk and mixed with Tarpana * should be applied 
(to the seat of the disease). In cases of Vata-Rakta 
involving the concerted action of two or three of the 
Doshas, the remedy consists in applying such drugs in 
combination as are possessed of the efficacy of subduing 
the action of each of them. 15. 

Guda-Haritaki and Pippali-Vardha- 

mana Yogas : — Haritaki with treacle may be used 
in all types of Vata-Rakta. As an alternative, the 
patient should be enjoined to use Pippali, pasted with 
miik or water, every day (in the following way).+ The 
number of Pippali should be increased by five or ten 
respectively on each successive day till the tenth day of 
its use ; after which period the number of Pippali should 
be decreased (by a similar number) on each successive 
day till it is reduced to the original five or ten. The 
patient should live on a diet of milk and rice only (during 
the entire course of this treatement). This medicine 
which is known as the Pippali-Vardhamana,:|: proves 
efficacious in cases of Vata-Rakta, chronic fever 
(Vishama-Jvara), aversion to food, jaundice, enlarged 
spleen, piles, cough, asthma, cedema, phthysis, loss of 
appetite, heart-disease and ascitis. 16. 

Clarified butter, cooked in milk with the paste of 
the drugs of the Jivaniya group, should be used in 

* Flour of barley or fried grain, dissolved in water, is known as 
Tarpana. 

tThe dosage should begin originally with five or ten Pippalis according 
to the strength of the patient. 

X Maharshi Charaka mentions this Yoga in the chapter on Rasayana 
and prescribes it also in the treatement of Udara. Chakradatta mentions 
the use of this medicine in the treatment of liver and spleen and of 
fever. 



304 THE SUSHRUTA SAMHITA. [Chap. V. 

anointing (the body of the patient). A plaster, composed 
of Sahd, Sahadevd, Chandana, Murvd, Mustd, Piydla, 
S'atdvari^ Kas'eru , Padma-kdstha Yashti-madhu, S'ata- 
pushpd (A. D. Vidari) and Kushtha, pasted together with 
milk and mixed with the cream of clarified butter, should 
be applied (hot) to the affected locality. A plaster 
composed of Saireyaka, Atarushaka, Vald, Ati-vald 
Jivanti and Sushazi^ pasted together with the milk of a 
she-goat, should be likewise applied (to the seat of the 
disease). As an alternative, the diseased locality should 
be plastered with the pastes of Kds'marya^ Yashti- 
madhu and Tarpana mixed together ; or it should be 
treated with Pinda-Taila, prepared by cooking Madhu- 
chchhishta (bee's wax), Manjishthd, resin, and Ananta- 
mula in milk* (and oil taken together). 17-20. 

In all cases of Vata-Rakta, old and matured clarified 
butter boiled with the expressed juice of Amalaka 
should be prescribed as drinks. The affected part 
should be washed or sprinkled with old and matured 
clarified butter, boiled with a decoction and paste 
(Kalka) of the drugs belonging to the Kdkolyddi group, 
or with those of the Jivaniya group, or with the decoc- 
tion of Sushavi, or of Karavellaka. The Vala-Tailat 
should be used for sprinkling and immersing purposes, 
and as drink and Vasti-karma (enemas). 

Diet: — The diet should consist of articles made 
of old and matured S'ali or Shashtika rice, wheat or 
barley, taken with milk | or with the soup of Mudga 

* Milk four times of oil should be taken. 

I The "Vald-Taila" described in the medical treatment of Mudha- 
garbha, ch. XV. 

X In the case of Vata-roga with preponderant Pitta, the patient should 
take the food with milk ; in the preponderance of Vayu, with the soup of 
Jangala meat; and in the preponderance of Kapha, with Mudga-soup, 
devoid of any acid combination. 



Chap, v.] CHIKITSA STHANAM. 305 

pulse or flesh of Jdngala animals and devoid of any 
acid combination.* 21. 

Frequent blood-letting should be resorted to and 
measures, such as, emetics, purgatives, Asthapana and 
Anuvasana should be adopted in cases of the aggravated 
Doshas-|* (involved in the case). 22. 

Memorable Verses :— A case of Vdta- 

Rakta of recent growth, proves readily amenable to the 
remedial measures described before. Long-standing, i.e., 
chronic cases (of Vdta-Rakta) are never perfectly cured, 
but can only be palliated. The application of poul- 
tices (Upandha), of medicinal washes or sprinkles (Pari- 
sheka), hot-plasters, anointings (Abhyanga), spacious 
and comfortable bed-chambers which do not admit of 
too large an influx of air, shampooing, and the use 
of soft and pleasant beds and soft pillows, are chiefly 
recommended in a case of Vata-Rakta ; whereas physical 
exercise, sexual intercourse, display of anger, the use of 
heat-making, saline, acid and difficultly digestible food 
and eatables producing eff^use serus or slimy matter in 
the bodily channels, and sleep in the day-time (should 
be deemed extremely injurious and hence) should be 
studiously refrained from. 23. 

The Medical Treatment of Apata- 

naka : — The medical treatment of a patient suffering 
from Apatainaka (hysterical convulsions), not exhibiting 
fixedness of gaze and arched eye-brows, with an absence 

* In the case of Vata-roga, with a preponderance of Pitta, the patient 
should take his food with milk ; in the preponderance of Vayu, with the 
soup of Jangala meat ; and in the preponderance of Kapha, with Mudga- 
soup, devoid of any acid combination. 

t In the preponderance of Kapha, emetics should be employed ; in 
the preponderance of Pitta, purgatives should be given ; and in the pre- 
ponderance of Vayu, Anuvasana and Asthapana measures should be 
resorted to. 

39 



306 THE SUSilRtJTA SAMHltA. [Chap. V. 

of perspiration, quivering, delirium and the numbness 
of genitals, found not to fall on the ground but capable 
of being supported on his arms (Akhattd-pati) and whose 
trunk is not bent or arched on its posterior (dorsal) side 
(Vahirayama), may be attempted (with success). The body 
of the patient should be first anointed with emulsions 
(Sneha) and then fomented ; strong medicated snuff 
should then be administred for purifying (the accumu- 
lated mucus in) the head. After that the patient should 
be made to drink a clear potion prepared of clarified 
butter, cooked in combination with a decoction of the 
drugs constituting the Viddri-gandhadi group, extract 
of meat, milk and milk-curd, so as to arrest the further 
expansion of the deranged Vayu into the system. 

Traivrita Ghrita :— A decoction of the Vayu- 
subduing drugs, such as, Bhadra-ddrvddi, etc., barley, 
Kulattha pulse, Kola, and the flesh of the Anupa and 
Audaka animals with the Pancha-Vargas* should be 

* According to Jejjata, "Pancha-Vargam" means the flesh of the five 
kinds of Anupa animals, z//s., Kulachara, Plava, Kos'astha, Padin and 
Matsya (fishes). 

The reading here is doubtful. The term "Audaka" in the compound 
word ** Sanupaudaka-mamsam " seems to be redundant, inasmuch as 
•'Audaka" animals are included in the "Anupa" class. (Sutra, chap. 
XLVI. Page 487, Vol I). In this case the word " Pancha-vargam " also 
seems to be only an explanation of the term "Anupa" meaning the fiive 
kinds of Anupa flesh, and it seems to have surreptitiously crept into the body 
of the text from the marginal notes of some authoritative manuscript copy 
of the book. If, however, we are to abide by the current reading of the 
book, "Pancha-varga" cannot mean the five kinds of flesh in the presence 
of the word ''Audaka" mentioned separately, as Jejjata would have it. In 
that case it can only mean either the five groups of Pancha-mulas, viz., the 
major Pancha-mulas, the minor Pancha-mulas, the Valli-Pancha-mulas, 
the Kantaka-Pancha-mulas and the Tiina-Pancha-mulas. (Sutra, chap. 
XXXVIII, Pages 355-6, Vol. I), as some would explain it to mean. Others, 
however, prefer the reading as it \i and explain the term "Fancha-varga" 
to be the five kinds of medicinal drugs mentioned before in the sentence, 



I 



Chap, v.] CriIKITSA STHANAM. 307 

made. The decoction, thus prepared, should be mixed 
with milk and fermented rice-gruel, etc., and then cooked 
with an adequate quantity of clarified butter, oil, lard 
and marrow by casting Kalka (paste) of the Madhura 
(Kakolyadi group) into it This Traivrita Ghrita* (lit. 
consisting of clarified butter with three other lardaceous 
articles), thus prepared, should be administered to 
Apatanaka-patients in potions and diet, in effusions 
and immersions, in anointings and errhines, as well as 
in Anuvasana measures. Diaphoretic measures should 
be applied according to the prescribed rules. In a 
case marked by an unusually aggravated condition of 
the YAyu, the patient should be made to stand neck-deep 
in a pit tolerably warmed or heated with burning husks, 
and- cow-dung. As an alternative, Palas'a leaves should 
be strewn over a hot stone-slab or over a hot oven, 
after having sprinkled wine over them, and the 
patient should be laid full length upon these leaves, or 
fomentations should be made with Ves'avdra, Kris'ara 
and Pdyasa. 24—25. 

An oil, cooked in combination with the expressed 

viz., the Vataghna drugs, Yava, Kola, Kulaltha and flesh. Oihers, again, 
mean by the term "Pancha-varga" the five parts, viz., leaf, fruit, flower, 
bark and root, of the Vataghna drugs mentioned in the sentence. 

We have, however, the authority of Vagbhata and Chakradatta in our 
side to accept the first view that the term "Audaka" is redundant, in- 
asmuch as they have not read the word "Audaka" in their compilations. 
—Ed. 

* According to Dallana, four seers of clarified butter, oil, lard and 
marrow (each weighing one seer), sixteen seers of Kanji, etc., sixtetn seers 
of milk, sixteen seers of the decoction and one seer of the Kalka (paste) 
should be taken in its preparation. But Gayadasa is of opinion that 
four seers of milk should be taken instead of sixteen seers. 

Four seers of Ghrita, etc., four seers of milk, six seers of Kanji, six 
seers of the decoction and one seer of the Kalka (paste) are generally 
taken byexperienced physicians in its preparation.— Ed. 



308 THE SUSHRUTA SAMHITA. [Chap. V. 

juice oi Mulaka, Eranda, Sphurja, Arjaka, Arka^ Saptald 
and S'amkhini should be used in washing (Parisheka), 
etc., the body of an Apatdnaka-patient. Potions con- 
sisting of sour Dadhi (milk-curd) mixed with powdered 
pepper and Vachd, or of oil, clarified butter, lard, 
or honey, mixed with the same things and taken 
in an empty stomach, prove curative in cases of 
Apatanaka. 26. 

These remedial measures are applicable in cases of 
Apatanaka when the action of the aggravated Vayu 
alone preponderates. In a case involving the concerted 
action of two or mere of the Doshas, drugs, remedial 
to each of them, should be combinedly employed. 
Medicinal liquid errhines {Avapida) should be employed 
after the subsidence of a severe attack. The fat or lard 
of a cock, crab, Krishna-fish, porpoise or of a boar 
should be taken* by the patient. As an alternative, 
he should be made to drink (a potion consisting of) 
milk boiled with Vdyu-subduing drugs (Das'a-mula, etc.), 
or a gruel (Yavdgu) composed of barley, Kola, Kulattha- 
pulse and Mulaka, cooked with curd, oil and clarified 
butter. Oily purgatives, Asthapana and Anuvasana 
measures, should be employed if the paroxysm does 
not subside even in ten days. Medicines and remedial 
measures laid down under the head of Vata-vyddhi 
and the process of Raksha-karma, should be likewise 
adopted (in cases of Apatanaka). 27. 

Treatment of Pakshaghata :— A physi- 
cian is enjoined to take in hand the medical treatment 
of a patient laid up with Pakshaghata, unattended 
by a discolouring of the skin, but having pain in the 
affected part, and who habitually observes the rules of 

* Vriddha Vagbhata recommends external application with these 
lards. 



Chap, v.] CHIKITSA STHANAM. 309 

diet and regimen and who can afford to pay for the 
necessary accessories. The affected part should be first 
anointed and then fomented. Mild emetics and 
purgatives should be subsequently employed for the 
purpose of cleansing the system. Medicated Anuvdsana 
and Asthdpana measures should then be employed, after 
which the general directions and remedial measures, 
laid down under the treatment of Akshepaka^ should 
be followed and employed at the proper time Appli- 
cations of the Mastikya-Siro-vasti with the Anu-taila for 
anointing the body, of the articles of Salvana-Sveda 
for the purpose of poulticing, and of the Vahi-taila as an 
Anuvdsana measure, are the marked features of the 
medical treatment of this disease, and should be followed 
carefully for a continuous period of three or four 
months. 2g. 

These preceding remedies as well as dry fomenta- 
tions (Ruksha-sveda) and errhines, which possess 
the virtue of subduing the deranged Vdyu and 
Kapha should be likewise employed in cases of Manya- 
stambha. 29 

Treatment of Apatantraka : —Fasting 

is prohibited in cases of patients suffering from Apa- 
tantraka (Apoplectic convulsions). Emetic, Asthapana 
and Anuvdsana measures are likewise forbidden. The 
passage of respiration should be blown open by violent 
breathings in the event of its being choked up with an 
accumulation of the deranged Vayu and Kapha. The 
patient should be made to drink a potion consisting of 
Tumburu, Pushkara, Hingu, Amla-vetasa^ Haritaki and 
the three (ofilicinal) kinds of salts, with a decoction 
of barley.* As an alternative, four seers of clarified 

* Chakradatta quotes this in the chapter on the treatment of colic 
(s'ula), but does not read *Amla-vetasa' there. 



310 THE SUSHRUTA SAMHITA. [Chap. V. 

butter, cooked in combination with sixteen seers of 
milk, two Pala weight of Sauvarchala salt and fifty of 
Haritakis should be prescribed for the use of the patient. 
All other remedial agents, possessing the virtue of 
subduing the deranged Vayu and Kapha should be 
likewise employed. 30. 

Treatment of Ardita :— A patient suffering 

from Ardita f/acial Paralysis) should be treated with the 
measures and remedies laid down under the head of 
Vata-vyadhi in the event of his being found to be suffi- 
ciently strong and capable of affording the neces- 
sary expenses for his treatment. Errhines, Mastlkya- 
Siro-vasti, inhalation of the smoke (Dhuma-pdna) from 
medicated drugs, poulticing (Upandha), unguents and 
Nddi-sveda, etc., are the special features of the medical 
treatment of this disease. After that, a decoction should 
be made of the drugs constituting the groups of Trina- 
Pancha-mula, Mahd-Pancha-mula, Kdkolyddid^nd Viddri- 
gandhddi groups, aquatic bulbs, and the flesh of animals 
which are aquatic in their habits (Audaka) and those 
which frequent swampy places (Anupa), by boiling them 
together with a Drona measure of milk and double the 
quantity of water. The decoction should be considered 
boiled when three quarter parts of its original weight of 
the liquid has been evaporated and should then be 
strained. The decoction thus prepared should be boiled 
with a Prastha measure of oil (four seers) and be removed 
from the fire when the oil is well mixed with the milk. 
The compound (oil and milk) thus prepared should be 
allowed to cool down and then churned. The churned 
off cream (Sneha) should be again boiled wuth the drugs 
of the Madhura (Kdkolyddi) group, Mdsha-parni and 
milk (four times that of the original oil). This 
medicated oil is known as the Kshira-Taila and should 



Chap, v.] CHIKITSA STHANAM. 3II 

be administered as potions and unguents, etc, to an 
Ardita-patient The above preparation with clarified 
butter in the place of oil is known as the Kshira- 
sarpih and it should be used as an Akshi-tarpana (eye- 
lotion). 31—32. 

Venesection should be duly resorted to in the affect 
ed parts, according to the directions given before, in cases 
of Sciatica, Gridhrasi, Vis'vachi (Synovitis of the knee- 
joints), Kroshtuka-sirah, Khanja (lameness), Pangula, 
Vata-kantaka, Pdda-ddha, Pada-harsha, Ava-vahuka and 
Vadhiryya and in cases where the deranged Vayu would 
be found to be seated in a Dhamani. Measures 
and remedies laid down under the head of Vata- 
vyadhi should be adopted, except in a case of 
Ava-vahuka 33. 

The expressed juice of green ginger, made lukewarm 
after mixing it with (equal quantities of) oil, honey and 
Saindhava salt, should be poured into the cavity of the 
ear in a case of (acute) ear-ache. As an alternative, 
the urine of a she-goat, or oil and honey, or oil with 
the urine (of a cow) mixed with the expressed juice of 
Mdtulunga, pomegranate and tamarind, or the oil boiled 
and prepared with Surd, Takra, Sukta, salt and 
the urine (of a cow), should be poured into the cavity of 
the ear ; fomentation should be given (to the interior of 
the affected organ) after the manner of Nddi-sveda. 
The remedial measures for Vdta-vy^dhi should be re- 
sorted to. We shall, however, revert to the subject in 
the Uttara-Tantra. 34. 

The patient should be made to drink a potion of 
Sneha-Lavana* dissolved in an adequate quantity of 
water, or the powders of the Pippalyadi group (with an 

* Sneha-Lavana has been described in Chap. 4. (treatment of 
Vata-vyadhi) para. 24. 



312 THE SUSHRUTA SAMHITA. [Chap. V. 

adequate quantity of water), or clarified butter, thickened 
or saturated with pulverised asafoetida and Yava-kshdra 
(Carbonate of Potass), in cases of Tuni and Prati-tuni. 
Applications of Vastis should also be resorted to. 35. 

In a case of Adhmaina (Tympanites), the remedy 
should consist in the applications of powders of the 
Dipaniya (appetising) group, of suppositories (Phala-varti), 
Vastis and digestive drugs (Pachaniya group). The 
patient should also be advised to observe a rigid fast 
and his abdomen should be fomented with hot palms. 
After that he should break his fast with boiled rice pre- 
pared with appetising (Dipana) drugs such as, Dhanyaka, 
Jiraka, etc. Similarly, a case of Pratyafcdhmaina should 
be treated with fasting, emetics and appetising drugs. 
Cases of Ashthilat or Pratyashthilai should be treated 
as a case of Gulma and internal abscess, to all intents 
and purposes. 36-38. 

Hingvadi-Vati : — A compound consisting of 
asafoetida, Trikatu, Vachd, Ajamodd, Dhanyd, Aja- 
gandhd, Dddimba, Tiniidi, Patha, Chitraka, Yava-kshara, 
Saindhava salt, Vid salt, Sauvarchala salt, Svarjikd- 
kshdra^ Pippali-mula, Amla-vetasa, S'athi^ Pushkara-mula, 
Hapushd^ Chavyd, Ajdji and Pathyd, powdered together 
and treated many times with the expressed juice of Mdtu- 
lunga in the manner of Bhavana* saturation, should be 
made into boluses, each weighing an Aksha (two ToUs) 
in weight. One (such) pill should be taken (in an empty 
stomach) every morning in all diseases of the deranged 
V^yu. This compound proves curative in cough, 
asthma, internal tumour (Gulma), ascites, heart-disease, 

* '* Bhavana" consists in soaking a powder or a pulverised compound 
with the expressed juice or decoction of any drugs or with any liquid and 
in getting it dry (generally). This process should be cotinued many times 
(generally seven times) in succesion. 



Chap, v.] CHIKITSA STHANAM. 3x3 

tympanites, aching pain at the sides, in the abdomen 
and in the bladder, in cases of an aversion to food, 
retention of stool, strangunary, enlarged spleen, piles, 
Tuni and Prati-tuni. 39. 

IVIemorable Verses :— From the symptoms 

or leading indications, exhibited in each case and from a 
close examination thereof, it should be inferred whether 
the Vayu alone has been deranged or whether it has 
combined with any other Dosha, or has affected any 
other fundamental principle (Dhdtu) of the organism as 
well ; and the medical treatment should follow a 
course, so as not to prove hostile to the Doshas or the 
Dha'tus (organic principles) implicated in the case, in 
its attempt to subdue the aggravated Vdyu. In a 
case of cold, compact and painful swelling (appearing 
in any part of the body) owing to the combination of 
the deranged Vdyu with fat, the treatment should be 
identical with that of a swelling in general. 40-41. 

Uru-Stambha :— The deranged Vdyu, sur- 
charged with the local fat and Kapha gives rise to a 
swelling in the region of the thigh which is known 
as Uru-stambha ; others designate it as Adhya-Vatta. 
This disease is marked by lassitude and an aching pain 
in the limbs, by the presence of fever, horripilation and 
somnolence and by a sensation of coldness, numbness, 
heaviness, and unsteadiness in the thighs, which seem 
foreign to the body. 42. 

Its Treatment :— The patient should be made 
to drink a potion consisting of the pulverised compound 
known as the Shad-dharana-yoga ; or of the drugs con- 
stituting the Pippallyadi group, dissolved in (an adequate 
quantity of) hot water without using any oleaginous 
substance ; or a lambative, composed of pulverised 
Triphald and Katuka mixed with honey, should be 

40 



314 THE SUSHRUTA SAMHITA. [Chap. V. 

used ; or a potion, consisting of Guggulu or S'ildjatu 
dissolved in cow's urine, should be administered. These 
compounds subdue the aggravated Vdyu surcharged 
with deranged fat and Kapha and prove curative in 
heart-disease, an aversion to food, Gulma and internal 
abscesses. A medicinal plaster composed of Karanja 
fruits and mustard seeds, pasted with a copious quantity 
of cow's urine should be applied hot to the affected part, 
which may be as well fomented with cow's urine mixed 
with alkali (Kshdra) ; or the locality should be sham- 
pooed with articles devoid of any oily substance. The 
diet of the patient should consist of old and matured 
Sydmaka, Kodrava, Udd^la and Sdli rice with the soup of 
dry Mulaka or Patola, or of the flesh of animals of 
the Jdngala group cooked without clarified butter or 
vegetables iS^dkd) cooked without salt. The use of oil 
and of lardaceous substances in general (Sneha-karma) 
should, however, be prescribed after the deranged fat 
and Kapha have (totally) subsided. 43. 

Therapeutic properties of Guggulu : 

— Guggulu is aromatic, light, penetrating into the mi- 
nutest parts of the body, sharp, heat-making in potency, 
pungent in taste and digestion, laxative, emulsive, slimy, 
and wholesome to the heart (Hridya). New Guggulu is 
an aphrodisiac and a constructive tonic. Old GrUggulu 
is anti-fat and hence reduces corpulency. It is 
owing to its sharpness and heat-making potency 
that Guggulu tends to reduce the Vdyu and the 
Kapha ; it is its laxativeness that destroys the Malas 
(refuge deposits in the Srotas) and the deranged 
Pitta ; its aroma removes the bad odours of the 
Koshtha ; and it is its subtle essence that improves 
the appetising faculty. Guggulu should be taken 
every morning with a decoction of Triphald^ Ddrvi and 



Chap. V.J CHIKITSA STHANAM, 315 

Patola or with that of Kus,'a roots* ; it may also be 
taken with an adequate quantity of cow's urine, or with 
alkalinef or tepid water. The patient should take 
boiled rice with soup, milk, or extract of meat after the 
Guggulu has been digested. Diseases such as internal 
tumour (Gulma), urinary complaints (Meha), Uddvarta, 
ascites, fistula-in-ano, worms in the intestines, itches, 
an aversion to food, leucoderma (Svitra), tumour and 
glands (Arvuda>, sinus, Adhya-Vdta, swelling (oedema), 
cutaneous affections (Kushtha) and malignant sores and 
ulcers readily yield to it, if used for a month (with the 
observance of the regimen of diet and conduct laid down 
previously). It also destroys the deranged Vdyu incar- 
cerated in the Koshtha, bones and joints, just as a 
thunderbolt will destroy trees. 44. 

Thus ends the fifth Chapter of the Chikilsita Sthanam in the Sus'ruta* 
Samhita which deals with the medical treatment of Mahd-Vafa-Vyddhi. 

* Some explain that a third decoction should be that of Triphala, 
Ddrvi, Patola and Kus'a grass taken together.— Dallana. 

The decoctions may be prepared separately with Triphala, Darvi, 
Patola and Kus'a.— ^aT. 

t Some read '^Kshira" (milk) in the place of ''Kshara" (alkali). 



CHAPTER VL 

Now we shall discourse on the medical treatment of 
Haemorrhoids (A rsas). i. 

The remedial measures in haemorrhoids may be 
grouped under four subheads ; namely, the employment of 
(active) medicinal remedies, the application of an alkali 
(into the seat of the disease), actual cauterization (of the 
polypii) and surgical operation. A case of recent origin 
involving the action of theDoshas to a slight degree and 
uncomplicated with any grave or dangerous symptom 
and complication may prove amenable to medicine 
alone. Deep-seated polypii. which are soft to the touch 
and markedly elevated and extended (external — D R.), 
should be treated with alkaline applications, while 
those which are rough, firm, thick and hard should be 
cauterized with fire. Polypii which are raised, exuding 
and slender at the roots should be surgically treated. 
Hcemorrhoids which are held amenable to medicine and 
are not visible (to the naked eye) should be treated with 
the help of medicines alone. Now, listen to the 
procedure to be adopted in the treatment of Ars'as 
which would require alkaline applications, a cauteriza- 
tion, or a surgical operation. 2. 

Application of Kshara:— The body of 

the patient suffering from haemorrhoids, in the event of 
possessing sufficient strength, should be anointed and 
duly fomented. He should be made to eat warm but 
demulcent food (Anna) in a fluid state (of a gruel-like 
consistency) to alleviate the excessive pain in- 
cidental to the action of the deranged Vdyu. In a 
season neither too hot nor too cold, and when the 



Chap. VI.] CHIKITSA STHANAM. 317 

sky is cloudless, he should be placed in a raised 
up position in a clean and well-equipped place on 
a plain slab or on a clean bed with his head resting 
on the lap of an attendant and the anal region 
exposed to the sun. In this position the waist should 
be made to elevate a little and to rest on a cushion 
of cloths or blankets. The neck and the thighs of 
the patient should be drawn out, and then secured with 
trappings and held fast by the attendants so as not to 
allow him to move. Then a straight and slender-mouthed 
instrument (somewhat like the modern rectal speculum^ 
lubricated with clarified butter, should be gently inserted 
into the rectum and the patient should be asked to 
strain down gently at the time. After seeing the 
polypus (through the speculum), it should be scraped 
with an indicator and cleansed with a piece of cotton or 
linen after which an alkali should be applied to it. 
The exterior orifice of the instrument should be closed 
with the palm of the hand after this application and kept 
in that manner for a period that would be required to 
utter a hundred words. 

Then after having cleansed the polypus, a fresh 
application should be made according to the strength 
of the alkali and the intensity of the aggravated Doshas 
involved in the case. Further application of the alkali 
should be stopped and the polypus washed with 
fermented rice-gruel (Dhdnyamla), curd-cream, Sukta, 
or the juice of acid fruits, in the event of its having 
been found to have become a little flabby, bent down, 
and to have assumed the colour of a ripe Jambu fruit. 
After that it should be cooled with clarified butter 
mixed with Yashti-Madhu, the trappings should be 
removed and the patient should be raised up and placed 
in a sitting posture in warm water and refreshed with 



3l8 THE SUSHRUTA SAMHITA. [Chap. VI. 

sprays of cold water, or, according to some authorities, 
with warm water. Then the patient should be made to 
lie in a spacious chamber, not exposed to the blasts of 
cold winds (specially), and advised as regards his diet and 
regiinen Each of the remaining polypii, if any, should 
be cauterized with the alkaline application at an interval 
of seven days. In case of a number of polypii, those 
on the right side should be first cauterized and then 
those on the left, and after that those on the posterior 
side ; and lastly those that would be found to be in 
front. 3. 

Polypii, having their origin in the deranged Vs^yu and 
Kapha, should be cauterized with fire or alkali ; while 
those, which are the outcome of the deranged Pitta and 
vitiated blood should be treated with a mild alkali alone. 
A perfect and satisfactory cauterization (Samyag^- 
dagdha) of a polypus should be understood from such 
symptoms as, restoration of the bodily Vdyu to its 
normal condition, relish for food, keenness of the appe- 
tite, lightness of the body and improvement in strength, 
complexion and pleasure. An over-cauterized (Ati- 
dagdha) polypus gives rise to such symptoms as, 
cracking of the region of the anus, a burning sensation 
(in the affected locality), fainting, fever, thirst, and 
pn fuse haemorrhage (from the rectum), and consequent 
complications ; while an insufficiently cauterized (Hina- 
dagdha) polypus is known by its tawny brown colour, 
smallness of the incidental ulcer, itching, derangement 
of the bodily Vdyu^ discomforts of the cognitive organs 
and a non-cure of the disease. 4. 

A large polypus, appearing in a strong person, should 
be clipped off (with a knife) and cauterized with fire. 
As regards an external polypus full of extremely 
aggravated Doshas (Vdyu, Pitta, Kapha and blood) no 



Chap. VI.l CHIKITSA STHANAM. 319 

Yantra should be used, but the treatment should consist 
of fomentation, anointing, poulticing, immersion, 
plastering, evacuating measures (Visrava), cauterization 
with fire and alkali and a surgical operation. 
Measures laid down under the head of Rakta-pitta 
should bs resorted to in cases of haemorrhage 
(from the seat of affection). Remedies mentioned 
in connection with dysentery (Atisdra) should be em- 
ployed in cases of a looseness of the bowels ; whereas 
in cases of constipation of the bowels oily purgatives 
should be administered, or the remedies for UdAvartta 
should be adopted. These rules shall hold good in the 
cases of treating (cauterization, etc) a polypus occurring 
in any part of the body whatsoever. 5. 

A polypus should be caught hold of and an alkali 
should be applied thereto with a Darvi, or a brush 
(Kurcha), or an indicator (Salaka). In a case of a 
prolapsus of the anus, cauterization should be made 
without the help of any Yantra (speculum). 

Diet : — In all types of haemorrhoids, the diet 
should consist of wheat barley, Shashtika rice or S'dli 
rice, (boiled) and mixed with clarified butter, to be taken 
with milk, Nimba-soup, or Patola-soup. The patient 
should be advised to take (his meal) with Vdstuka, 
Tanduliyaka^ Jivanti, Upodikd, As'va-vald, tender 
Mulaka, Pdlanka, As ana, Chilli, Chuchchu, Kaldya, 
Valliy or any other S'dkas (pot-herbs;, according to the 
nature of rhe Doshas involved in the case Any other 
oleaginous, diuretic, laxative and appetising (Dipana) 
diet possessing the virtue of curing piles should also be 
prescribed. 6. 

After the cauterization of the polypus, as well as in 
a case where no cauterization would be necessary, the 
body of the patient should be anointed with clarified 



320 THE SUSHRUTA SAMHITA. [Chap. VI. 

butter and oil, etc., and measures both general and 
specific (mentioned below and in accordance with the 
Dosha or Doshas involved) should be employed for the 
purpose of improving the digestive powers and to 
alleviate any aggravation of the Vaiyu. He should 
be made to drink a potion consisting of clarified butter 
cooked with the Vdyu-subduing and appetising (Dipana) 
drugs* (Kalka and Kvatha) mixed with the powders 
of Hingu, etc., (described in the treatment of Maha-Vdta- 
vyAdhl, chapter. V). In a case of Pittaji-Ars'as, clarified 
butter prepared by cooking it with the drugs of the 
Pippallyddi and Bhadra-ddrvddi\ groups, should again 
be cooked with the decoction of Prithakparnyadi group 
and the Kalka of the Dipaniya (Pippallyddi) group, and 
given as a potion to the patient. In a case of haemorr- 
hoid due to the action of the deranged blood \ 
(Rakt^rsas), the clarified butter should be cooked with 
a decoction of Manjishthd, Murungi, (D. R. Surangi), 
&c., while in a case of one due to the action of the 
deranged Kapha, the clarified butter should be cooked 
with a decoction of the drugs constituting the 
Suras ddi group. The supervening distresses should 
be alleviated by the remedial measures peculiar to 
each of them . 7 . 

Cauterization with fire or with an alkali or any surgical 

* Such as the decoction of the drugs of the Bhadra-datvddi (Vayu- 
subduing) and Pippalyadi (Dipaniya) group?. This Ghrita should be 
prescribed in a VsCtaja Arsas. 

t The epithet "Bhadra-darvadi-pippallyddi" in the phrase "Bhadra- 
darvadi-pippallyadi-sarpih" seems to be included into the body of the 
text through an accident. In our opinion, it is only an annotation of the 
phrase **Dipaniya-Vdta-hara-siddha" occurring in the last sentence. — Ei. 

X The Kalkas of the Pippallyadi group should also be taken in the 
preparation of the two kinds of medicated clarified butter to be used in 
Raktars'as, and Pittiis'as. ^Z)a//a»»a, 



Chap. VI. J CHIKITSA STHANAM. 32 1 

operation in the present disease should be effected by 
introducing the Yantra (speculum) into the rectum (with 
the utmost care, inasmuch as an error happening in any 
of these cases may bring on impotency, swelling (Sopha), 
a burning sensation, epilepsy, rumbling in the intestines, 
retention of stool and urine, dysenteiy, diarrhoea, or may 
ultimately end in death. 8. 

Rectal Speculum :--Now we shall describe 
the dimensions of the Yantras (and the materials of 
which they are made of). The instrument may be 
made of iron, ivory, horn or wood. It should be made 
to resemble the teat of a cow. In the case of a male 
patient, it should be four fingers in length and five 
fingers in circumference ; whereas in the case of a female 
patient, the length should be commensurate with that of 
the palm of the hand (of the same length as before — 
D. R.) and six fingers in circumference. The instrument 
should be provided with two separate apertures in its 
inside, one for seeing the interior of the rectum and the 
other for applying an alkali, or actual cautery (Agni) to 
the polypus, since it is impossible to apply fire and 
alkali through the same aperture. The circumference 
of the aperture in the upper three fingers of the instru- 
ment should be like that of a thumb. There should 
be a bulb-like protrusion of the same width, at the 
bottom, and above it a space of half a finger's width. 
Thus we have briefly described the shape of the 
instrument. 9-10. 

Alepa (plasters) :— Now we shall describe the 
plasters to be applied to the haemorrhoids (to cause 
their spontaneous dropping off). The first consists of 
pulverised turmeric mixed with the milky exudation of 
the Snuhi tree. The second contains of the cock- 
evacuations and pulverised Gunjd, turmeric SLnd-Ptppa/t 

41 



322 THE SUSHRUTA SAMHITA. [Chap. Vl. 

pasted with the urine and bile of a cow. The third 
is compounded of Danti^ Chitraka, Suvarchikd and 
Ldngali pounded together and made into a paste with 
cow's bile. The fourth consists of Pippali^ rock-salt, 
S'irisha-SQQds and Kushtha pasted with the milky juice 
of an Arka^ or Snuhi plant. An oil cooked in combina- 
tion with Kdsisa (sulphate of iron), Haritdla (yellow 
orpiment), rock-salt, As'vamdraka, Vidanga, Putika, 
Kritavedhana, Jamhu, Arka, Uttatndrani, Danti^ 
Chitraka, Alarka and Snuhi-m\\V, and used as an 
unguent, leads to the falling off of the polypus, ii. 

Internal piles :— Now we shall describe the 
remedial measures which bring about the falling off of 
the invisible (internal) haemorrhoids. The patient should 
take Haritakl with treacle every morning ; or a hundred 
Haritakis should be boiled in a Drona measure of cow's 
urine and the patient, observing a strict continence, 
should take with honey every morning as many of them 
as suit his constitution ; or he should be made to 
take every day a paste made of the roots of Apdmdrga 
with the washings of rice and with honey. S'atdvari 
pasted with an adequate quantity of milk or ;a Karsha 
measure of) the powders of Chitraka mixed with a copious 
quantity of good Sidhu wine, or a gruel (Mantha) 
(neither extremely thick nor thin), or powdered barley 
or wheat mixed with Takra and Bhalldtaka powder, 
should be administered without any salt. A quantity of 
Takra should be kept in an earthen pitcher, plastered 
inside with a paste of Chitraka roots, and given to 
the patient in food and drinks whether fermented or 
not, A Takra should also be separately prepared as in 
the preceding manner with Bhdrgi^ Asphotd, barley, 
Amalaka and Guduchi and administered similarly ;. this 
is called the Takra-kalpa (butter-milk compound). 12. 



Chap. VI.3 CHIKITSA STHANAM. 323 

A medicated Takra should also be prepared with 
Pippali^ Pippali-mula, Chavya^ ChiU'aka^ Vidanga, 
S'unthi and Haritaki^ in the manner described above, 
(and given to the patient), who should abstain from 
taking any solid food, but live only on (this) Takra for a 
period of one full month ; or he should be given milk 
boiled with a decoction of S'ringavera, Punarnavd and 
Chitraka, or a condensed decoction (Phdnita) of the 
bark of Kutaja roots mixed with an after-throw of the 
powdered drugs of the Pippalyddi group and honey. 
The patient should be made to partake of the medicinal 
compound known as the Hingvadi-churua,* described 
in the chapter on Maha-Vdta-vyddhi, and be made to 
live either on milk, or on Takra. As an alternative, he 
should take Kulmdsha boiled in Kshdrodaka (alkaline 
water) prepared from Chitraka-voois and made saline 
with a liberal after-throw of Yava-kshdra ; or he should 
take milk boiled with the Kshdrodaka (alkaline water) 
prepared from Chitraka-roots, or Kulmasha boiled with 
the alkaline water prepared from the ashes of burnt 
P aids a ; or he should drink frequent potions of clarified 
butter mixed with the alkali made of the ashes of either 
Patola, Apdmdrga, Vrihati, or Paldsd wood ; or drink 
Takra mixed with the Kalka of the roots of Kutaja and 
of Vanddka ; or take the alkaline water of Putika 
mixed with a Kalka of Chitraka, Putika and Ndgara ; 
or use the clarified butter boiled in an alkaline solution-f- 
with the powdered drugs of the Pippalyddi group, 

* In a preponderance of Vayu and Kapha, Takra should be taken as 
diet ; whereas milk should be taken in a case of the preponderance of 
vitiated blood. 

t During the period when the above mentioned alkaline preparations 
are used, the diet of the patient should consist of clarified butter, milk 
and meat-soup for fear of the loss of the Ojo-Dhatu, 



324 THE SUSHRUTA SAMHITA. [Chap. VI. 

added to it by way of an after-throw ; or he should take 
every morning one or two Palas of black sesamum 
(according as required), with cold water. These 
measures prove remedial in cases of haemorrhoids and 
tend to improve the digestion. 13. 

Dantyarishta : — A Tula weight* (twelve seers 

and a half) of the following drugs, ziz., Das'a-mula, 

Danti, Chitraka and Hai'itaki should be boiled with 

four Drona measures of water till reduced to one quarter 

part (one Drona). The decoction, thus prepared, should 

be cooled down, filtered, mixed with a Tuld measure of 

treacle and preserved into a receptacle which formerly 

contained clarified butter, which should then be 

kept buried for a month in a heap of unthrashed 

barley At the close of this period an adequate dose 

of this preparation should be given to the patient 

every morning. This medicine proves beneficial \n 

cases of haemorrhoids, chronic diarrhoea (Grahani), 

jaundice, obstinate constipation of the bowels (Udavartta) 

and in an aversion to food. It is also a good stomachic 

agent. 

AbhayariShtat :— Two Pala weight of each 
of the following drugs, viz., Pippali^ Maricha, Vidanga, 
Elavdlukd and Lodhra, five J Pala weight of Indra- 
vdruni, ten Pala weight of the inner pulps of the Kapittha 
fruit, half a Prastha measure (one Prastha is equal 
to two seers) of Haritaki and one Prastha weight of 
Amalaki, boiled together with four Drona measures of 

* Some are of opinion that one Tula weight of each of the drugs 
should be taken ; but Gayaddsa does not say so. 

t Charaka also reads this under the name of Abhaydrishta. 

X Experienced physicians recommend two and a half Pala weight of 
Indra-Vdruni in lieu of five Palas for its astringent taste. Charaka, 
liowever, recommends oply "half a Pala." 



Chap. VI.] CHIKITSA STHANAM. 325 

water until reduced to one quarter of its quantity. This 
decoction should be filtered (through a piece of linen) 
and cooled down, after which two Tula weight of 
treacle should be added to it. The whole preparation 
should be then kept in a receptacle which formerly 
contained clarified butter, and be kept buried half a 
month in a heap of unthrashed barley. After the lapse 
of the said period, the patient should be made to drink 
(an adequate quantity of) this preparation every 
morning according to his strength. This Arishta 
proves curative in cases of an enlarged spleen, 
impaired digestion, chronic diarrhoea (Grahani), Ars'as, 
heart-disease, jaundice, cutaneous affection, ascites, 
Gulma, oedema (Sopha), and worms in the intestines, 
and improves the strength and complexion of the 
body. 14 

Anointing (Sneha-karma), fomentation, use of emetics 
and purgatives and the application of Anuv^sana and 
Asthcipana measures should be employed in cases of 
haemorrhoids due to the action of the deranged Vaiyu*. 
The use of purgatives is recommended in the Pittaja 
type ; soothing or pacifying (Samsamana) measures in 
the Raktaja type ; and S'ringavey-a and Kulattha in the 
type caused by the action of the deranged Kapha. All 
the preceding remedies should be combinedly employed 
when the concerted action of all the Doshas would 
be detected. As an alternative, milk boiled with the 
proper drugs may be administered in every case. 15. 

Bhallataka-yogaf :~Now we shall describe 
the mode of using Bhallattaka in cases of haemorrhoids. 

* Some are of opinion that the Rishis do not read this line. But as 
Gayadasa explains it, so Dallana, he tells us, also does the same. 

t A physician should apply this medicine after a due consideration 
and according to the physical condition of the patient. 



326 THE SUSHRUTA SAMHITA. [Chap. VI. 

A ripe and fresh Bhalldtaka should be cut into two, 
three or four pieces and a decoction should be made of 
them in the usual way. The patient should be made 
to drink four Tola weight of this cold every morning 
after lubricating or anointing his tongue, palate and 
lips with clarified butter, and should take his chief 
meal with milk and clarified butter in the afternoon. 
The number of Bhalldtakas in preparing the decoction 
should be increased by one every day till the fifth 
day, (and the quantity of the decoction to be drunk 
by the patient should be similarly increased). After 
that, the number of Bhalldtakas (and consequently 
the quantity of the decoction to be taken) should be 
increased by five every day. This method should be 
followed till the number of the Bhallatakas reaches 
seventy, after which it should be decreased every 
day by five until it is reduced to five Bhallatakas 
only (and five Sukti measures of the decoction). 
Subsequently the number of Bhallataka (and the dose) 
should be diminished by one (and one Sukti measure 
respectively) every day,until it is reduced to the original 
one (and one Sukti measure). By taking a thousand 
Bhallatakas in this manner, one may get rid of an attack 
of any kind of Kushtha and Ars'as, and, having 
become strong and healthy, may live for one hundred 
years. i6. 

Other forms of Bhallataka-yoga : — 

The oil extracted from or pressed out of Bhallatakas, 
in the manner laid down in the chapter on Dvi-vrana, 
should be taken in a dose of one Sukti (four Tolas) every 
morning. The patient, as in the preceding case, should 
take his meal ( of boiled rice, milk and clarified 
butter) after the digestion of the oil with a similar good 
Qfifect. As ai) alternative, oil should be extracted froni 



Chap. VI.] CHIKITSA STHANAM. 327 

the marrow of Bhalldtakas and the patient, after cleansing 
his system with emetics and purgatives, etc., and regulat- 
ing his diet in the order of Peya, etc. should enter 
into a spacious chamber, protected from the blasts of the 
winds and take two Palas, or one Pala weight of the oil 
according to his strength A meal of boiled rice, 
milk and clarified butter, etc., should be taken after the 
oil had been fully digested. The oil should be conti- 
nued, in this way, for a month, the regimen of diet 
should be strictly observed for a period of three months 
and the patient should abstain from anger, etc, during 
this period. The use of this oil, in the above mentioned 
way, not only ensures a radical cure of the disease with 
all its complications, but would increase the duration of 
life to a hundred years with the glow of youth and 
health and with an increment in the powers of memory, 
retention and wisdom. The application of this oil for 
every one month will extend one's life for a period 
of one hundred years. In the same way a continuous 
use for ten months would enable him to live for a 
thousand years. 17. 

IVlemorabie Verses :-Vrikshaka (Kutaja) 

and Bhallattaka* prove as much curative in cases of 
all kinds of haemorrhoids, as Kshadira and Vijaka are 
effective in cases of cutaneous affections (Kushtha). 
Cauterization with fire, or with an alkali, proves as 
much palliative in cases of external haemorrhoids as 
turmeric proves soothing in those of Prameha. 18-19. 

Medicated Ghritas, appetising drugs, electuaries, 
medicinal wines, Ayaskriti and Asava should be 
prescribed in cases ol haemorrhoids, according to 
the nature and intensity of the Doshas involved 

Boiled with sixteen times of water in the event of the Bhallataka 
being dry, otherwise with eight times of water only. 



328 THE SUSHRUTA SAMHITA. [Chap. VI. 

therein. Voluntary suppression of any natural urgings 
of the body, sexual intercourse, riding on horse-back, 
etc., sitting on the legs and such diets as would 
aggravate the Doshas, should be avoided in cases of 
haemorrhoids. 20-21. 



Thus ends the sixth Chapter in the Chikitsita Sthanam of the Sus'ruta 
Samhita which deals with the medical treatment of Ars'as. 



i 



I 



CHAPTER VII. 

Now wc shall discourse on the medical treatment 
of urinary calculus, etc. (Asmari). i. 

Metrical Texts :— Asmari (urinary calculus, 
etc) is a dangerous disease and is as fatal as death itself. 
A case of recent origin (acute) proves amenable to 
medicines, while an enlarged or chronic one requires 
surgical operations. The remedial measuies, in the 
order of anointing, etc, should be employed in the first 
or incipient stage of the disease, whereby the entire 
defects with their causes {i.e., roots of the disease) would 
be radically cured. 2. 

Treatment of Vataja Asmari :— Clarified 

butter cooked with a decoction of Pdshdnabkeda, Vasuka, 
Vas'ira, As'mantaka, S'atdvari^ S'vadamstrd^ Vrihati, 
Kantakdrikd, Kapotavamka, A'rtagala, Kakubha^^ Us'ira, 
Kubjaka, Vrikshddani^ Bhalluka, Varuna, S' dka-phala^ 
barley, Kulattha, Kola and Kataka fruits and with the 
Kalka of the drugs constituting the group of Ushakddi, 
speedily brings about the disintergration of As'mari 
(urinary calculi, etc.) due to the action of the deranged 
Vaiya. Milk, Yavagu (gruel), a decoction, soup, or an 
alkali, properly prepared with the above Vayu-subduing 
drugs should also be administered as food and drink 
in the above cases. 3. 

Treatment of Pittaja Asmari : —Simi- 
larly a medicated clarified butter cooked with the 

* Chakradatta reads "Kopotavaklra" in place of "Kapotavamka" 
"Kanchana" in place of 'Kakubha" ; and ''Gulmaka" in place of 
"Kubjaka " From an examination of Dallana it appears that 
• 'Kachchhaka" is also a reading of "Ivakubha. " 

42 



330 THE SUSHRUTA SAMHITA. [Chap. VII. 

decoction of Kus'a,Kds'a, S'ara, Gundrd, Itkata^ Morata, 
As'mabhid, S'atdvari^ Viddri, Vdrdhi^ S'dli-mula, Tri- 
kantaka, Bhalluka, Pdtald, Pdthd, Pattura, Kuruntikd, 
Punarnavd*, S'irisha, with the paste (Kalka) consisting 
of S'ildjatu, Madhuka (flower) and the seeds oi Indivara\ , 
Trapusha and Ervdruka, would speedily bring about 
the disintegration of Pittaja As'mari (calculi, etc.). 
An alkali, Yavagu (gruel), soup, a decoction, or milk, 
properly prepared with the above Pitta-subduing drugs, 
should also be prescribed as food and drink in these 
cases. 4. 

Treatment of Kaphaja Asmari :— 

The use of medicated clarified butter prepared from 
the milk of a she-goatf and cooked with the paste 
(Kalka) of the drugs constituting the Varunddi groupj, 
Guggulu, Eld, Harenu^ Kushtha, the Bhadrddi group, 
Maricha. Chitraka, Surdhvd and the Ushakddi group, 
leads to the speedy disintegration and expulsion of the 
As'mari (stone, etc.) due to the action of the deranged 
Kapha. So also the use of an alkali, Yavdgu (gruel), 
soup, milk, or a decoction, properly prepared with the 
above Kapha-subduing drugs, is recommended as food 
and drink in such cases. 5. 

A potion consisting of the powdered fruit of the Pichuka, 
Amkola, Kataka, S'dka and /;^<^2Wr^ mixed with treacle§ 

* Chakradatta reads "Punarnave" i.e.^ both the kinds of Punarnava. 

t Jejjata explains *'Indivara" as 'Nilotpala.' But Gayadasa does not 
support this. 

X S^me say that "Aja-sarpih" is superfluous. Chakradatta reads 
''■m ^^II^l^ "^ ^^1#^l^^f*(:'' in place of "^^t ^^^if^^ ^I^^I- 
fT^?r^ ''"' meaning thereby that the decoction of the Varunadi-gana is to 
be used. Chakradatta's reading seems to be the correct one and is 
observed in practice with good results. — Ed. 

§ The quantity of treacle, to be taken, should be equal to the entire 
quantity of the powders ; anci hot water should be use4 — PaUan^^. 



Chap. VII.] CHIKITSA STHANAM. '33'r 

and water proves beneficial in cases of Gravel (Sarkard). 
The bones of the Krauncha, camel and ass, as well as 
the drugs known as S'vadamshtrd* Tdlamuli^ Ajamodd^ 
Kadambaxoots and Ndgara pounded together and ad- 
ministered through the vehicle of wine (Surd) or hot 
water, leads to the disintegration of Sarkara gravel). 
The milk of an ewe mixed with powdered Trikantaka- 
seeds and honey should be used for seven days for the 
disintegration and separation of an Asmari. 6-y, 

Alkaline Treatments:— An alkali should be 

prepared from the ashes of the drugs used in the prepara- 
tion of the aforesaid medicated clarified butters, by dis- 
solving and filtering them in ewe's urine The alkali should 
then be slowly boiled with an alkali similarly prepared 
from the dung of domestic animals, with the powders of 
Trikatu and the drugs of the Ushakddi group thrown 
into them as an after-throw. It proves curative in cases 
of stone, Gulma, and gravel. Alkaliesf from burnt bark 
of sesamum, Apdmdrga^ plantain, P aids' a and barley 
taken with the urine of an ewe destroy the gravel 
(S'arkard). As an alternative, the alkalies of Pdtald and 
Karavira should be used in the preceding manner. 8-9. 
Two Tola (Aksha) weights of the pastes of S'va- 
damstrd, Yashti-madhu and Brdhmi (mixed with ewe's 
urine) should be given to the patient ; or the expressed 
juice of the Edakd, S'obJidnjana and Mdrkava (with the 
said urine) should be given, or a potion consisting of the 
pasted roots of the Kapotavamka with Kanjika, or Sura, 
etc., should be administered. Milk boiled with the afore- 
said drug (Kapotavamka) should be taken by a patient 

* Some explain it as **Gokshura-seeds" and others as "Markataka- 
seeds." 

t Four or six Tola weight of an alkali should be dissolved and filterrd 
for a number of times before use. 



332 THE SUSHRUTA SAMHITA. [Chap. VII. 

in case there is pain (in urinating). Milk boiled with 
Triphald or Varshdbhu should be administered as a 
drink and a decoction of the drugs of the Vira-tarddi 
group should be employed in all these cases.* lo. 

A physician should have recourse to the following 
measures (surgical operations) in cases where the 
above-mentioned decoctions, medicated milk, alkalies, 
clarified butter and Uttara-vasti (urethral syringe) of 
the aforesaid drugs, etc., would prove ineffective. Surgical 
operations in these cases do not prove successful even in 
the hands of a skilful and experienced surgeon ; so 
a surgical (Lithotomic) operation should be considered 
a remedy that has little to recommend itself. The death 
of the patient is almost certain without a surgical opera- 
tion and the result to be derived from it is also uncertain. 
Hence a skilled surgeon should perform such operations 
only with the permission of the king. 11-12. 

IVIodes of Surgical Operations :— The 

patient should be soothed (Snigdha) by the application of 
oleaginous substances, his system should be cleansed with 
emetics and purgatives and be slightly reduced thereby ; 
he should then be fomented after being anointed 
with oily unguents ; and be made to pertake of a 
meal. Prayers, offerings and prophylactic charms 
should be offered and the instruments and surgical 
accessories required in the case should be arranged 
in the order laid down in the Agropaharaniya chapter] 
of the present work (Sutra-sthanam, ch. V.). Thej 

* Dallana recommends the use of Triphala boiled with milk in] 
cases of pain accompanying Plttaja As'mari, while that boiled with] 
Varshabhu is advised to be given for the alleviation of pain in a case of! 
Vdtaja or Kaphaja As'mari. The drugs of Vira-taradi group should be] 
used with milk, clarified butter, a decoction, Yavagu (gruel), food, etc.,j 
and also for bath, immersion, etc. 



Chap. VII.] CHIKITSA STHANAM. 333 

surgeon should use his best endeavours to encourage 
the patient and infuse hope and confidence in the 
patient's mind. A person of strong physique and un- 
agitated mind should be first made to sit on a level 
board or table as high as the knee-joint. The patient 
should then be made to lie on his back on the table 
placing the upper part of his body in the attendant's lap, 
with his waist resting on an elevated cloth cushion. 
Then the elbows and knee-joints (of the patient) should 
be contracted and bound up with fastenings (S'ataka) or 
with linen. After that the umbclical region (abdomen) 
of the patient should be well rubbed with oil or with 
clarified butter and the left side of the umbelical region 
should be pressed down with a closed fist so that the 
stone comes within the reach of the operator. The 
surgeon should then introduce into the rectum, the 
second and third fingers of his left hand, duly anointed 
and with the nails well pared. Then the fingers should 
be carried upward towards the rope of the perineum i.e , 
in the middle line so as to bring the stone between the 
rectum and the penis, when it should be so firmly and 
strongly pressed as to look like an elevated Granthi 
(tumour), taking care that the bladder remains con- 
tracted but at the same time even. 

PrOg^nosiS-M. Text :— An operation should 
not be proceeded with nor an attempt made to extract 
the stone (Salya) in a case where, the stone on being 
handled, the patient would be found to drop down 
motionless (/.^., faint) with his head bent down, and eyes 
fixed in a vacant stare like that of a dead man, as an 
extraction in such a case is sure to be followed by death. 
The operation should only be continued in the absence 
of such an occurrence. 

An incision should then be made on the left side 



334 TiiK SUSHRUTA SAMHitA. tChap. Vn. 

of the raphe of the perineum at the distance of a barley- 
corn and of a sufficient width to allow the free egress of 
the stone. Several authorities recommend the opening 
to be on the right side of the raphe of the perineum for 
the convenience of the operation. Special care should be 
taken in extracting the stone from its cavity so that it 
may not break into pieces nor leave any broken particles 
behind (i.e., inside the bladder), however small, as they 
would, in such a case, be sure to grow larger again. 
Hence the entire stone should be extracted with the 
help of an Agravaktra Yantra (a kind of forceps the 
points of which are not too sharp). 13. 

Lithotomic Operation in a female : — 

In a woman, the uterus (Garbhds'aya) is adjacent to the 
urinary bladder, hence the stone should be removed 
by making an oblique and upward incision, otherwise 
a urine-exuding ulcer might result from the deep 
incision in that locality. Any hurt to the urethra 
during the operation would be attended with the 
same result even in a male patient. An incision 
made only on one side of the organ in a disease other 
than that of stone, baffles all attempts at healing ; 
while an ulcer incidental to an incision made on both 
its sides, should be deemed incurable. An ulcer 
incidental to an incision made on either side of the 
bladder in extracting a stone might be healed up, in- 
asmuch as medicinal potions and fomentations, etc., 
employed for the healing of a surgical wound, lead 
to the healing of the wound in the bladder ; secondly 
because the surgical opening is only made large enough 
for the extraction of the stone as recommended in the 
authoritative books ; and thirdly because an increase 
in the quantity of urine contributes to an increase in 
the size of the stone and hence a slight secretion of that 



Chap. VII.] CHIKITSA STHANAM. 335 

fluid or employment of diuretic Peyas, etc., are not 
attended with any injurious effects. 

Post-Surgical IVleaSUreS ".—After the ex- 
traction of a stone, the patient should be made to sit in 
a Droni (cauldron) full of warm water and be fomented 
thereby. In doing so the possibility of an accumula- 
tion of blood in the bladder will be prevented ; however 
if blood be accumulated therein, a decoction of the Kshira- 
trees should be injected into the bladder with the help 
of a Pushpa-netra (urethral Syringe). 14-15- 

Memorable Verse : — Stones and the accu- 
mulated blood in the bladder would be speedily expelled 
by means of injecting a decoction of the Kshira-trees 
into it with the help of a Pushpa-netra (urethral 
Syringe). 16. 

For the clearance of the urinary passage, a treacle 
solution should be given to the patient ; and after tak- 
ing him out of the Droni, the incidental ulcer should be 
lubricated with honey and clarified butter. A Yavagu, 
boiled with the drugs* possessed of the virtue of cleans- 
ing or purifying the urine, and mixed with clarified 
butter, should be given to the patient in a warm state 
every morning and evening for three consecutive days. 

After that period a diet (meal) of rice well 
boiled and mixed with milk and a large quantity of 
treacle, should be given (to the patient) in small quan- 
tities for ten days for the purification of the blood and 
the secretion of urine as well as for the purpose of esta- 
blishing secretion in the ulcer. The patient should be 
made to partake of a diet (of rice) with the soup of the 
flesh of Jangala animals and the expressed juice of acid 
fruits after the lapse of these ten days. 17. 

• The urine-purifying drugs are the Trina-Panchamulas, Gokshura, 
Kasamarda, Pashanabheda, etc. 



336 THE SUSHRUTA SAMHITA. [Chap. VII. 

After that period, the body of the patient should be 
carefully fomented for ten successive days by applying 
any warm oleaginous substance or with any warm 
medicinal fluid (Drava-Sveda). As an alternative, the 
ulcer should be washed with the decoction of (the 
bark of) the Kshira-Vrikshas, A paste of Rodhra, 
Madhuka, Manjishtha and Prapaundarika (pounded to- 
gether), should be applied then to the ulcer. A medicated 
oil or Ghrita cooked with turmeric and the preceding 
drugs should be applied to the ulcer. The accumulated 
blood in the affected part should be removed with the 
help of a Uttara-vasti (urethral Syringe). The ulcer 
should be cauterized with fire in the manner described 
before in the event of the urine not flowing through 
its natural passage after the lapse of seven days. 
After the urine takes its natural course, Uttara-vasti, 
Asthdpana and Anuvasana measures should be employed 
with the decoction of the drugs belonging to the 
Madhura- Varga. 

A seminial stone or gravel (S'arkard) spontaneously 
brought down into the urinary passage should be re- 
moved through the same passage. The urethra should be 
cut open and the stone should be extracted with a hook 
(Vadis'a) or any other instrument in the case of its not 
being expelled out by the passage. The patient should 
refrain from sexual intercourse, riding on horse back or 
on the back of an elephant, swimming, climbing on 
trees and up mountains and partaking of indigestible 
substances for a year even after the healing of the 
ulcer. i8. 

Parts to be guarded in Lithotomic 

Operations: —The Mutra-vaha (urine-carry ingi and 
the S'ukra-vaha (semen-carrying) ducts or channels, the 
Mushka-srotas (cords of the testes), the Mutra-praseka 



Chap. Vll.j CHIKITSA STHANAM. 337 

[urinary) channels, the Sevani (the raphe of the perineum), 
the Yoni (uterus, vagina, etc.), the Guda (rectum j and the 
Vasti (bladder) should be carefully guarded at the time of 
performing a lithotomic operation. Death results in the 
event of the urine-carrying channels being in any way 
hurt during the operation owing to an accumulation of 
urine in the bladder. Similarly, any hurt or injury to the 
semen-carrying ducts at the time, results in death or in 
impotency of the patient ; a hurt to the cords of the 
testes begets an incapacity of fecundation ; a hurt to the 
urinary ducts leads to a frequent dribbling of urine ; while 
a hurt to the Yoni (uterus, vagina, etc.), or to the 
raphe of the perineum gives rise to extreme pain. 
The symptoms which characterise a hurt to the rectum 
or to the bladder have been described before. 19. 

Memorable Verses:— The surgeon who is 

not well cognisant of the nature and positions of the 
Marmas or vulnerable parts seated in the eight Srotas 
(ducts) of the body such as, the raphe of the perineum, 
the spermatic cords, the cords of the testes and the 
corresponding ones in females (Yoni), the anal region, 
the urinary ducts, the urine-carrying ducts, and the 
urinary bladder and is not practiced in the art of 
surgery brings about the death of many an innocent 
victim. 20. 

Thus ends the seventh Chapter of the Chikitsita Sthanam in the 
Sus'ruta Samhita which deals with the treatment of Urinary calculus. 



43 



CHAPTER VIII. 

Now we shall discourse on the medical treatment of 
Fistula-in-ano, etc., (Bhagandara). r. 

The disease admits of being divided into five different 
groups, of which the two, known as S'ambukavarta and 
S'alyaja (traumatic), should be regarded as incurable, 
and th^ rest as extremely difficult to cure. 2. 

The General Treatment :— The eleven* 

kinds of remedial measures commencing with Apatar- 
pana up to purgatives (as described under the treatment 
of Dvi-vrana) should be employed as long as any 
fistular ulcer would remain in an insuppurated stage. 
The patient should be soothed by the application of 
medicated oil, etc., and his body should be fomented by 
immersing him in a receptacle of warm water, etc. as 
soon as suppuration would set in (and even after the 
ulcer had burst). Then having laid him on a bed 
and bound his hands and thighs with straps as des- 
cribed under the treatment of Haemorrhoid, the surgeon 
should examine closely as to where the mouth of the 
fistula is directed, outward or inward, and whether 
the ulcer itself is situated, upward or downward. Then 
the whole cavity or receptacle of pus (sinus) should 
be raised up and scraped out with an Eshani (indicator 
or probe). In a case of inter-mouthed fistula, the patient 
should be secured with straps (as before described) 
and asked to strain down. An incision should then 
be made by first directing the indicator when its mouth 
would become visible from the outside. Cauterization 

* Apatarpana, Alepa, Parisheka, Abhyanga, Sveda, Vimldpana, 
Upandha, Pachana, Visrdvana, Sneha, and Vamana. 



\ 



Chap. VIII.] CHIKITSA STHANAM. 339 

with fire or an alkali is a general remedial measure which 
may be resorted to in all the types of this disease. 3-4. 

Specific IWeasurcs— IVI. Texts :- Incases 

of the ^ataponaka type all the small Vranas about 
the anus should be first incisioned and the principal sinus 
in the locality should not be looked after until these 
small ones had been healed up. The connected abscesses 
should be respectively incisioned on the external side, 
while the unconnected ones should not be opened at 
the same time in order that they may not run into 
one another and be thus converted into a wide-mouthed 
ulcer. The urine and the faecal matter are found in each 
case to flow out of the cavity of such a wide-mouthed 
ulcer ; and aching pains in the rectum and a rumbling 
sound in the abdomen, due to the action of the aggrav- 
ated Vdyu, are experienced. Such a case is enough 
to confound even a well-read and experienced physician. 
Hence the mouth of a fistula of the Sataponaka type 
should not be opened with a broad incision. 

Forms of incision : — An experienced surgeon 
should know that the Ldngalaka, Ardha-Langalaka, 
Sarvatobhadraka and the Gotirthaka forms of incision 
should be the different shapes of incision, in a case of 
a many-mouthed S'ataponaka. An incision equal in its 
two sides is called the La(ugalaka (curvilineal), while the 
one with one arm longer than the other is named the 
Ardha-Laingalaka. An incision made in the region of 
the anus in the shape of a cross (crucial) and a little 
removed from the raphe of the perineum, is called the 
Sarvatobhadraka by men conversant with the shapes 
of surgical incisions. An incision made by inserting the 
knife in one side is called the Gotirthaka (longitudinal). 
All exuding (bleeding) channels in the affected region 
should be cauterized with fire by the surgeon. 



340 THE SUSHRUTA SAMHITA. [Chap. VIII. 

A case of the ^ataponaka type occurring in a 
person of timid disposition or of delicate constitution, is 
extremely difficult to cure. Medicinal fomentations en- 
dowed with the virtue of arresting secretion and alleviat- 
ing pain, should be quickly applied (to the seat of the 
disease). Fomentations with Kris'ard, or Pdyasa (por- 
ridge), made with the aforesaid Svedaniya (diaphoretic) 
drugs with a decoction of the drugs constituting the 
Vilvddi group, Vrikshddani and roots of the castor-plant 
mixed and boiled together with the flesh of the Ldva, 
Vishkira (a kind of bird) and that of animals living 
in swampy or marshy land or aquatic in their habits 
or Grdmya animals, and then kept in an oily pitcher and 
applied in the way of a Nddi-Sveda (fomentation through 
Nddi or pipe), should be at once applied to the seat of 
the ulcer. Sesamum, castor-seeds, linseed, iJ/<i5^^-pulse, 
barley, wheat, mustard-seeds, salts and the Amla-Varga 
(see Rasa-Vijndniya chapter) should be boiled in a 
saucer and the affected part or ulcer should be fomented 
therewith. After being fomented, the patient should 
drink (a potion consisting of) Kushtha, salts (the five 
officinal kinds of salts) Vachd^ Hingu and Ajamoda 
taken in equal parts and mixed with (an adequate 
quantity of) clarified butter, grape-wine (Mdrdvika), 
K^njika (Amla), Surci or Sauviraka.* Subsequent to 
that, the ulcer should be wetted with the Madhuka-oW 
and the rectum should be washed with medicated oils 
which would alleviate pain due to the action of the 
deranged and aggravated Vdyu. The preceding 
r^^edicinal remedies tend to bring about the outflow or 
evacuations of stool and urine through their natural 
channels or courses, and undoubtedly alleviate all 
acute and supervening distresses which specifically mark 

* By the use of this potion the digestive power is increased. 



Chap. Vlir.] CHIKITSA STHANAM. 34I 

the progress of the disease. We have described the treat- 
ment of a case of fistula- in-ano of the Sataponaka 
(sieve) type ; now listen to me about the treatment of 
the Ushtragriva (camel's neck) type of the disease. 5. 

Treatment of Ushtra-griva :— The ulcer 

should first be searched with a probe or director and, 
after an operation, an alkali should be applied to it. 
To remove all sloughed off or sloughing flesh and 
membranes cauterization with fire is forbidden. [The 
fissures of pus (sinuses) and sloughed off flesh should be 
first drawn out]. A plaster of clarified butter and 
pasted sesamum should then be applied to it, and the 
ulcer duly bandaged. Clarified butter should be constant- 
ly applied over the bandage which should be removed 
on the third day. Cleansing or disinfecting (^S'odhana) 
measures should then be used by the surgeon, accord- 
ing to the Doshas involved in the ulcer, and the 
successive healing (Ropana) measures resorted after its 
being properly purified (S'odhana). 6 

Treatment of ParisrsCvi :— In a case of the 

ParisrAvi (exuding) type, where there is bleeding and 
secretion from the ulcer, the sinus and the cavities of pus 
should be first removed and then cauterized with an alkali 
or with fire by an intelligent surgeon. The region of the 
anus should then be kept wet by the sprinkling of luke- 
warm Anu-toila (described in the chapter on V^ta-vy^dhi). 
Warm plasters, or poultices, mixed with Yavakshdra 
and the urine (of a cow) should then be applied. 
Decoction of the emetic drugs as the seeds of Madana, 
etc.), should also be sprinkled slightly on the affected 
part. The ulcer when found to be softened and 
nearly free from pain and secretion (owing to the 
preceding measures) should be searched with a probe 
and the principal sinus should be cut open and again 



342. THE SUSHRUTA SAMHITA. [Chap. VIII. 

completely cauterized with fire or with an alkali. The 
incisions should be made in the shape or form of a 
Kharjura-patra (leaf of the date-palm), Ardha-chandra 
(half-moon), Chandra-chakra (moon's disc), Suchi-mukha 
(needle's mouth), or Avdmmukha (with downward mouth). 
After that the ulcer should be purified with mild cleans- 
ing or disinfecting remedies (as described above) 7. 

In the case of an infant cauterization with fire or 
with an alkali, the use of strong purgatives and surgical 
operations are forbidden in the case of the disease 
(Bhagandara), whether outer-mouthed or inter-mouthed. 
Medicinal remedies calculated to be mild, though keen 
in their efficacy, should be used in such cases. A plug or 
a Varti in the shape of a wick and made of powdered 
Aragvadha, Haridrd and Kala, mixed with honey and 
clarified butter, should be inserted into the ulcer for 
purifying purposes. This medicinal compound speedily 
brings about the healing of a sinus, just as the wind 
will drive away a cloud. 8—9 

Treatment of Agantuka Bhagan- 
dara :— The sinus in a fistula of traumatic origin 
should be carefully cut open by a surgeon (with a knife) 
and cauterized, according to the rules laid down, with 
a red-hot Jambvoshtha (instrument) or with a red- 
hot director (SaUka). Vermifugal remedies should be 
applied to it, and measures laid down in connec- 
tion with the extraction of a Salya from the body 
should be carefully resorted to. 10. 

Treatment of Tridoshaja Bhagan- 
dara : — A case of Bhagandara, due to the concerted 
action of the three Doshas, should be treated without 
holding out any hope of recovery tot he patient's people, 
or should be given up as hopeless. The measures and 
remedies mentioned above should be adopted in 



Chap. VIII.] CHIKITSA STHANAM. 343 

succession in all types of Bhagandara. In the 
event of there being any pain in it, owing to the 
insertion of a knife or to any other surgical operation, 
luke-warm Anu-taila should be applied. As an alternative, 
the drugs possessed of the virtue of subduing the de- 
ranged Vdyu (Bhadra-ddrvddi and Erandadi groups) 
should be boiled in a pot covered by a lid having a 
hole or aperture on its top ; then the patient with his 
rectum anointed with oil, etc., should be made to sit in 
such a way over the said covered pot that the seat of 
the disease may be fomented with the warm fumes 
escaping through that aperture ; or Nddi-sveda should 
be applied to the affected region through a pipe in a 
recumbent posture to alleviate the pain. As an 
alternative, a hot bath should be prescribed for the 
alleviation of the pain. Sailvana Upanaiha (described in 
connection with the treatment of Vata-vyadhi and that 
with the skins of the Kadali Mriga, Lopaka and Priyaka, 
should be applied to the affected locality to subdue 
the pain. A potion of the drugs or substances such 
as, Trikatu, Vachd^ Hingu, salt (five kinds of salt) and 
Dipyaka, should be administered with wine, Kdnjika, 
Sauviraka and Kulattha-Soup, etc. 11-12. 

Jyotishmati^ Ldngalaki, S'ydmd^ Danti, Trivrit, Tila^ 
Kushtha, S'atdhvd,Golomi, Tilvaka^ Giri-karnikd^Kdsisa 
and the two kinds of Kdnchana-kshiri, compose the group 
which is possessed of the virtue of purifying (afistular sore). 
(The decoction of these substances should be applied for 
the purification of the ulcer). The sore of a fistula may 
be filled (healed^ up by the application of (a compound 
of) Trivrit, Tila, Ndgadanti, Manjishthd and rock-salt 
pasted together with milk and honey. A plaster (Kalka) 
consisting of Rasdnjana, turmeric, Ddru-kartdrd, 
Manjishthd^ Nimha leaves, Trivrit ^ Tejovati and Danti 



344 THE SUSHRUTA SAMHITA. [Chap. VIII. 

proves curative in a case of sinus. The drugs known as 
Kuskthuy Trivrit^ Tila^ Danti, Pippaliy Saindhava^ 
honey, turmeric, Triphala and sulphate of copper 
(Tuttha) are efficacious in purifying an ulcer. 13-16. 

Oil* cooked (slowly) with Pippali, Yashti-madhu^ 
Lodhra^ Kushtha, Eld^Harenu, Samangd (Bardha-krdnti), 
Dhdtaki flower, Sdrivd^ the two kinds of Haridrd, 
Priyangu^ Sarja-rasa^ Padmaka, P adrnd-kes^ ara^ Sudhd, 
Vachd.Ldngalikd, wax, and Saindhava should be regarded 
as a potent remedy in healing up the ulcer and curing 
fistula-in-ano. This remedy proves beneficial in cases of 
scrofula (Ganda-mald), Meha, ulcers and in the Mandala 
type of cutaneous affections as well. The drugs which 
constitute the Nyagrodhddi group are efficacious in dis- 
infecting (Sodhana) and healing up an ulcer. A medi- 
cated oil or Ghrita prepared with the preceding drugs 
proves curative in a case of fistula in-ano. Similarly 
a medicated oil duly cooked and prepared with the roots 
of Trivrit, Dantiy Haridrd, and Arka, as well as with 
Vidanga, Triphala^ milk of both Snuhi and Arka, honey 
and wax should be applied, as it is specifically efficacious 
in a case of Bhagandara. 17-19. 

Syandana Taila :— Oil slowly cooked and 

prepared (in the manner aforesaid) with Chitraka, Arka 
Trivrit, Pdthd, Malapu (Kakodumbara), Karavira, 
Sudhd (Snuhi), Vachd, Ldngalaki, Saptaparna^ Suvar- 
chikd and fyotishmati, is called the Syandana-Taila and 
should be constantly applied in a case of Bhagandara. 
It is efficacious in purifying, healing and imparting a 
natural skin-colour to the cicatrix. A learned and 
experienced physician should adopt the remedial 
measures for this disease according to the procedure laid 

* Four seers of oil, one seer of the drugs and sixteen seers of water 
should be taken at the time of preparation. 



Chap. VIIL] CHIKITSA STHANAM. 345 

down under the treatment of Dvi-Vrana, when there 
is any ulcer (vrana) in existence. 20, 

The bulb-like protrusion above the hole of the instru- 
ment (speculum), mentioned in connection with the 
treatment of Ars'as, should be removed and the instru- 
ment, now in the shape of a half-moon, should be used 
by an experienced surgeon in the treatment of a case of 
fistula-in-ano. The patient should refrain from sexual 
intercourse, physical exercise, riding, anger, and the use 
of heavy and indigestible articles of food for a full 
period of one year even after the healing up of the ulcer 
in a Bhagandara. 21 — 22. 

Thus ends the eighth Chapter of the Chikitsita Sthanam of the 
Sub'ruta-Samhita which deals with the treatment of Bhagandara. 



44 



CHAPTER IX. 

Now we shall discourse on the medical treatment of 
cutaneous affections in general (Kushtha). i. 

A cutaneous disease (Twag-dosha) originates through 
injudicious conduct of life such as^ partaking of large 
quantities of unwholesome food, or taking it before the 
previously eaten one is digested {i. e , eating too often), 
indulgence in incompatible articles of fare, voluntary- 
suppression of the natural urgings of the body, and 
improper application of medicated oil, clarified butter, 
or other lardacious articles. It is attributed even to the 
dynamics of sinful acts done by a man in this or in 
some prior existence. 2. 

Conduct of diet and regimen :— A 

person afflicted with any kind of skin disease should 
refrain from taking meat, lard, milk, curd, oil, Kulattha 
pulse, Mdsha pulse, Nishpdva, preparations and modifica- 
tions of sugarcane juice, acid substances, incompatible 
food, meals taken before the complete digestion of the 
preceding one, unwholesome and indigestible food, or 
food causing a burning sensation and some kind of 
internal secretion, day-sleep and sexual intercourse, 3. 

Regulation of diet and conduct: — 

The old and matured grain of S'dli, Shashtika, barley, 
wheat, Koradusha^ S'ydmdka, Udddlaka, etc., boiled and 
taken along with the soup(Supa) or a decoction* (Yusha) 

* An unsalted decoction of any substance not seasoned with any 
spices whatever is called Yusha, while the one salted and seasoned 
with spices is called Supa- In preparing the soup of any pulse, all husks 
should be carefully thrashed out and the grain should be slightly fried 
before boiling* 



Chap. IX.] CHIKITSA STHANAM. 347 

of either Mudga pulse or Adhaki pulse mixed with 
Nimba leaves and Arushkara are wholesome in a case 
of Kushtha. Preparations of any of the aforesaid 
grains may be taken with Manduka-parni^ Avalguja, 
Atarushaka and Rupikd flowers cooked in mustard oil or 
clarified butter, or with the soup prepared of the articles 
of the Tikta-varga (bitter group, mentioned in the Sutra- 
sthdnam). The cooked flesh of Jdngala animals, devoid 
of all fatty matter, should be given to a patient, 
habituated to the use of meat diet. The medicated oil, 
known as the Vajraka-Taila should be used for anoint- 
ing the body. A decoction of the drugs of the Arag- 
vadhddi group should be used for rubbing (Utsadana) 
purposes. Decoctions of Khadira should be employed 
in drinks, baths, washes, etc. The preceding rules are 
intended to regulate the diet and regimen of one suffer- 
ing from Kushtha (cutaneous affections). 4. 

Preliminary Treatment :— in the premo- 

nitary stages of the disease the system should be 
cleansed by the application of both emetics and pur- 
gatives. When the disease is found to invade the 
Tvak* only, a plaster prepared of the purifying drugs 
should be applied to the affected parts ; blood-letting 
and the use of medicinal decoctions and purifying and 
disinfecting plasters are the remedies to be employed 
when the desease would appear to infect the blood. 
The same remedies and Arishta, Mantha, Pras'a, etc , 
should be employed when the disease would be found 
to have invaded the principle of the Matmsa (muscles). 
Palliation and temporary respite are the only cure that 
can be offered in a case of the sin-begotten typef of the 

* Tvak here means Rasa or serum. 

t The type of Kushtha affecting the principle of Medas (fat) is 
generally supposed to be sin-begotten. 



348 THE SUSHRUTA SAMHITA. [Chap. IX. 

disease which is the fourth (in order of enumeration) and 
that even is purely contingent on the willingness and 
capacity of the patient to conform to a strict regimen of 
diet, conduct and dress. Blood-letting and purifying 
measures (emetics and purgatives) should be resorted to 
in such a case and then the special medicinal remedies 
prepared from BhallsLtakaf, Silaijatu, Gugguln, Aguru, 
Tuvaraka, Khadira, and Asana and the Ayaskriti 
should be used in accordance with the prescribed ; rules. 
The disease in its fifth form (is found to invade the 
bones and) should be given up as incurable. 3-6. 

Treatments of Doshaja Types :— in 

the first stage of Kushtha, the patient should be treated 
in accordance with the prescribed maxims (rules) of 
Sneha-pana. In a case of Vattaja-Kushtha, cil or 
clarified butter, cooked with (a decoction and Kalka of) 
Mesha-s'ringi, S'wadamshtrd, S'arngashtd, Guduchi 
and the drugs included in the group of Das'anmla 
should be used as drink and ointment. In cases 
of the Pittaja type, the patient should be made to 
drink (a potion consisting of) clarified butter prepared 
with (a decoction and Kalka of) Dhava^ As'vakarna^ 
Kakubha, Palds'a^ Pichu-mardha, Parpataka, Madhuka, 
Rodhra and Sainangd. In the Kaphaja type, clarified 
butter cooked with (a decoction and Kalka of) Piydla, 
S' ditty Aragvadha, Nimha, Saptaparna, Chitrakay 
Maricha, Vacha and Kushtha should be prescribed. 

* Bhallataka-preparations have been described in the treatment cf 
Ars'as, preparations of S'ilajatu, Guggulu, Aguru and Tuvaraka in the 
treatment of Prameha-pidaka, and Khadira, Asana and Ayaskriti prepara- 
tions in the treatment of Maha-kushtha. 

t Oil should be used in a case of Kapha-predominance, whereas 
clarified butter in that of Pitta-predominance. Others assert that clarified 
butter should be used for drinking purposes and oil for anointments. 



Chap. IX.] CHIKITSA STHANAM. 349 

The clarified butter cooked with (a Kalka and a decoc- 
tion of I Bhalldtaka.Ahhayd and" Vidanga^ or (the medicinal 
oils known as) the Tuvaraka Taila and the Bhallitaka 
Taila should be used in all types of Kushtha. 7-8. 

The IVIaha-tikta Ghrita:-A paste or 

Kalka should be made by pounding equal parts of 
Saptaparna^ Aragvadha, Ativishd^ Pdthd, Katu-rohini, 
Amritd, Trip/iald, Paiola, PicJiu-marda, Parpataka^ 
Durdlabhd, Trdyamdjid^ Mustd, Chandana, Padmaka^ 
Haridrd, Upakulyd, Vis'dld, Murvd, S'atdvari, S'drivd^ 
Indra-yava^ Atarushaka, Shadgranthd {I'achd), Mad/iuka, 
Bhu-ni7nha and Grishtikd*, This paste (Kalka) should be 
cooked with four times its own weight of clarified butter, 
with the juice of Amalaka, weighing twice as much as the 
clarified butter and with water weighing four times the 
quantity of the Amalaka juice. It should be constantly 
stirred (with a ladle), while being cooked. This medi- 
cated Ghrita is called the Maha(-tikta Ghrita, which 
proves curative in Kushtha, chronic fevers, haemorrhage, 
heart-disease, insanity, ApasmAra, Gulma, postular 
eruptions, menorrhagia, goitre, scrofula, elephantiasis, 
jaundice, erysipelas, impotency, itches and Pdma, etc. 9. 

The Tikta-Sarpih :— Two Pala weight of 

each of the following drugs, viz., Triphald, Patola, Pichu- 
marda, Atanishaka, Katu-rohini, Durdlabhd^ Trdyamdnd 
and Parpataka-\ should be taken and boiled together in 
a Drona measure of water. The boiling should be 
continued till it is reduced to one fourth of its original 
quantity. Then half a Pala weight of each of the 
following drugs, viz., Trdyamdnd, Musta, Indra-yava, (red) 

* Chakradatta does not read "Grishtika" but read "Us'ira" instead. 
He also takes both the kinds of "Haridrd," of "Upakulya" (Pippali) and 
of **Sariva". 

t Chakradatta reads ''Nis'a" in addition to the above drugs. 



350 THE SUSHRUTA SAMHITA. [Chap. IX. 

Chandana, Kirdta and Pippali should be pasted together. 
This pasted Kalka and the decoction should be cooked 
with a Prastha measure of clarified butter. The medicated 
Ghrita thus prepared is called the Tikta-Sarpih. Dis- 
eases such as Kushtha, chronic fever, Gulma, Haemor- 
rhoids^ GrahanI, edema, jaundice, erysipelas and impo- 
tency readily yield to the curative efficacy of this 
Ghrita. lo. 

Medicinal Plasters for Kushtha :— 

Having first soothed the patient with any of the pre- 
ceding medicated clarified butters and having his body 
fomented, the surgeon should have recourse to the veni- 
section. One, two, three, four, or five s iras (veins) of the 
patient may be opened (according to the circumtances). 
The raised or elevated patches on the skin should be 
scraped off, or should be kept constantly covered with a 
medicinal plaster. As an alternative, the characteristic 
patches of the disease should be first rubbed with 
the substance known as the Samudra-phena or with the 
leaves of S'dka^ Goji, or Kdkodumbara and a plaster 
(Lepa) composed of Ldkshd, Sarja-rasa, Rasdnjana, 
Prapunndda, Avalguj'a, Tejovati and the roots of 
As'va-mdraka, Arka, Kutaja, and Arevata, pasted with 
the urine or bile of a cow, should be applied to them; or 
Svarjikd, sulphate of copper, sulphate of iron, Vidanga, 
Agara-dhuma, Chitfaka, Katuka, Sudhd, turmeric and 
Saindhava pounded together with the urine or bile of a 
cow should be applied to the diseased localities. 

As an alternative, the alkali, prepared from the ashes 
of Palds'a wood in the prescribed manner, should 
be boiled with the powders of the preceding drugs ; it 
should be removed from the oven after reducing it to 
the thickness or consistency of a Phdnita and used in 
plastering (the diseased patches) ; or a plaster composed 



Chap. IX.] CHIKITSA STHANAM. 35t 

of fyotishka fruits, Ldkshd, Maricha^ Pippali and the 
leaves of the Jdti flower pasted together ; or a plaster 
composed of yellow orpiment, Manali-s'ild, the milky 
juice of Arka^ sesamum, S'igru and Maricha, pasted 
together ; or a plaster composed of Svarjikd^ KushtJia, 
sulphate of copper, Kiitaja, chitraka, Vidanga, Maricha 
^XiAManah-s'ild pasted together ; or a plaster of Haritaki, 
Karanjikdj Vidanga^ white mustard seeds, rock-salt, Goro- 
chand, Somardji and Haridrd pasted together should be 
applied to the diseased localities. 

IVIetrical Text:— The preceding seven medi- 
cinal plasters are possessed of the virtue of destroying 
or curing Kushtha in general. Now hear me deal with 
the remedies to be specifically employed in cases of 
ringworm (Dadru) and leucoderma (Svitra\ 1 1 . 

Treatment of Dadru : - h plaster composed 

of Kushthuy mustard seeds, S'ri-niketa, Haridrd, Trikatu 
and the seeds of Chakra-marda and of Mulaka pasted 
together with Takra (butter milk ?) should be applied to 
the ringworm. The disease is found to readily yield 
to the curative efficacy of a medicinal plaster, composed 
of Saindhava, Chakra-marda seeds, treacle, Kes'a7'a 
(Vakula), and Td^-ksha-s' aila (Rasanjana) pasted together 
with expressed Kapittha juice. Preparations of Hema- 
kshiri, Vyddhi-ghdta (Aragvadha\ S' iris ha, Nimba, 
Sarja, Vatsaka and Aja-karna (a species of Sarja) should 
be used in cases of ringworm of a virulent type for 
baths (D. R. Drinks),* plasters and rubbing. 12. 

Treatment of ^vitra :— In cases of sVitra 

and Pundarika, the patient should be made to drink a 
lukewarm decoction prepared with equal parts of the 

* In drinks or baths, a decoction should be used and in plasters and 
rubbings the ingredients should be pasted with Takra and the expressed 
juice of Kapittha. 



352 THE SUSHRUTA SAMHITA. [Chap. IX. 

roots of Bhadrd (Udumbara) and Malapu, The use 
of this potion would produce blisters on the patches. 
These blisters should be treated, after their bursting, with 
a plaster (Pralepa) composed of the ashes of the burnt 
skin of leopards and elephants and made into a thin 
paste with (mustard) oil. A plaster composed of the 
insect known as the Puti and the Kshara (alkali) of 
Aragvadha should be found to be the best remedy for 
Svitra. 13. 

All kinds of Svitra are found to readily yield to the 
application of a medicinal plaster made of the black 
ashes of a well-burnt cobra (Krishna-Sarpa) pasted with 
the oil of Vibhitaka. The white ashes of the said cobra 
mixed with one andahalf timeof its own weight of water 
should be filtered seven times in the manner of preparing 
an alkali. Mustard oil* should be cooked with this 
alkaline water weighing four times as much. An appli- 
cation of this oil proves curative in cases of Svitra. 14. 

The Prapunndda seeds. Kushtha and Yashti-jnadJiu 
should be pasted together with clarified butter. The 
plaster thus prepared should be given to a domestic 
white cock, purposely kept without food for a day and 
a half when it would evince any sign of hunger after the 
period. The dung of the said cock should then be 
collected after a full digestion of the said medicated 
drugs and applied as plasters on the affected patches for 
a month. It would bring about the cure (even) of 
internalf Svitras. 15. 

Well burnt ashes of the dung of an elephant];, mixed 

* This is the best medicine for curing S'vitra. 

t The internal S'vitras are those under the blisters produced by the 
application of the remedy mentioned first in the list. 

X S'ivadasa, the commentator of Chakradatta, says that some read 
g^^?p§^ in place of ijsi^?^? in which case it would mean "S'amatha." 



Chap. IX.] CHIKITSA STHANAM. 353 

with elephant's urine, should be filtered several times 
(twenty-one times or seven times) after the manner of an 
alkaline preparation. A Drona measure of this alkaline 
solution should be boiled with the seeds of the Somardji 
weighing a tenth part thereof. This compound should 
be taken down from the oven as soon as it assumes 
a glossy hue and should then be made into boluses. 
Having rubbed the diseased patches of Svitra, a 
plaster of these boluses should be applied to them 
which would soon assume a healthy and natural com- 
plexion. 16. 

The leaves and bark (Dala tvacham) of the Antra 
(mango) and the Haritaki* should be well soaked in a 
decoction of the same drugs (after the manner of a 
Bhavand-saturation) and made into Vartis {i,e.^ plugs). 
These Vartis should again be well soaked in the milky 
exudation of the Vata tree and lighted (with mustard oil) 
in a copper vessel used as an Indian lamp. The lamp 
black, thus produced, should be collected and well 
soaked in a decoction of Haritaki. Kildsa (a particular 
kind of Kushtha) is destroyed, if rubbed with this 
preparation for several times after having been lubri- 
cated with mustard oil.f 17. 

* According to some, both the leaves and bark of the "Amra" and 
of the "Haritaki" should be taken. 

t The leaves and bark respectively of the A'tnra and the Haritaki 
should be taken in the preparation. The whole stanza seems to be of faulty 
construction. Dallana, in his commentary, says that some read the fourth 
line as "<f^^ f%w ^^ifT ^EW?WT^^t^^tf% ^Ilf^^ ll'' This seems to 
be a better reading. It removes the difficulty in the construction, but it 
omits also the word "KilsCsa" from the text. This, however, is also an 
improvement, inasmuch as this preparation seems to be a remedy for 
Svitra (which is only a variety of Kilasa) like the preceding and the 
following ones ; and it seems unlikely that Sus'ruta would introduce a 
remedy for KilsCsa in general in the special treatment of S'vitra. 

45 



354 THE SUSHRUTA SAMHITA. [Chap. IX. 

A case of leucoderma would (undoubtedly) yield to 
the curative virtue of a medicinal plaster composed 
of Somardji seeds, Mdkshika, Kdkodumhara, Ldkshd, 
powdered iron, Pippali and Rasdnjana^ taken in equal 
parts and black sesamum equal to their combined 
weight, pasted with the bile of a cow and applied to the 
diseased patches. Similarly, a case of ^vitra would 
prove amenable to the application of peacock's bile, or 
of burnt Hrivera mixed with the said bile. i8. 

Various types of Svitra are cured with the appli- 
cation of either of the two following medicinal plasters. 
The first consists of Jw////^ (sulphate of copper), Haritdla 
(yellow oxide of arsenic), Katukd, Trikatu^ Simha (Rakta- 
Sobhdnjana), Arka^ Karavira, Kushtha^ Avalguja^ Bhal- 
Idtaka, Kshirini^ mustard seeds and Snuhi ; and the 
second consists of the leaves of the Tilvaka, Arishta 
(Nimba), Pilu and Aragvadha pasted together with the 
seeds of the Vidanga and Karavira and Haridrd^ Ddru- 
haridrd, Vrihati and Kantakdri. 19. 

Nila-Ghrita \~-Vdyasi, Phalgu and Tiktd each 
weighing one hundred Palas, two Prastha measures of 
powdered iron, three Adhaka (eight seers) measures of 
Triphald and two Adhaka measures of Asana should be 
boiled together with three Drona measures of water. This 
decoction should be taken down when reduced to one 
quarter of its original measure and cooked again with a 
quantity of clarified butter (weighing a quarter part of 
the former (decoction) and with a Kalka consisting of 
Indra-yava, Trikatu^ Tvak, Deva-ddru^ Aragvadha, Pdrd- 
vata-padiy Danti, Vdkuchi^ Kes'atdhva (Vakula) and 
Kantakdri. The patient should be made to drink this 
medicated clarified butter when the disease would be 
found to have attacked the Dhattus (fundamental prin- 
ciples of the organism), or to have become involved in the 



Chap. IX. 1 CHIKITSA STHANAM. 355 

aggravated Doshas of the system. The diseased patches 
should be rubbed with it, in the event of the afifection 
being found to be confined to the Tvak (skin) alone. 
Even the type of Kushtha, commonly held to be incur- 
able, has been found to prove amenable to the use of 
this medicated clarified butter, which is known as the 
Nila-Ghrita. 20. 

IVIahsC-Nila-Ghrita :-A Tuld* weight of 

the drugs known as Triphald^ Tvak, Trikatu, Suras d, 
Madayantikd, Vdyasi and Aragvadha and ten Pala 
weights of each of the drugs known as Kdkamdchi, 
Arka, Varuna, Danti, Kutaja, Chitrakay Ddru-haridrd 
and Kantakdri should be boiled together with three 
Drona measures of water. This decoction, boiled down 
or reduced to six Prastha measures, should be again 
boiled with the watery secretion of cowdung, cow's 
urine, milk, curd and clarified butter, each weighing an 
Adhaka, and with the Kalka (weighing one-fourth as 
much of clarified butter) of Bhu-nimba, Trikatu^ 
Chitraka, Kardnj'a-huit, Nilikd, S'ydmd, Avalguja, Pilu^ 
Nilini and Nimba-^o'WQ.rs, It is a curative for Kushtha. 
The rubbing of the diseased patches with this Ghrita 
imparts a healthy and natural colour to the skin in 
cases of Svitra or white leprosy. It also cures diseases 
like fislula-in-ano, worms in the intestines and Arsas. 
It is known as the Mahat-Nila-Ghrita.f 21. 

A compound consisting of cow's urine, Chitraka^ 
Trikatu and honey should be kept for a fortnight in a 

• A Tula is equal to a hundred Palas or twelve seers and a half of 
our modern measure. 

t Dallana, in his commentary, says that the two Ghritas (Nila and 
Mahd-Nila) seem to be spurious (Anarsha). But he has included them 
in his commentary as Jejjata and Gayaddsa have read and explained 
them before him. 



356 THE SUSHRUTA SAMHITA. [Chap. IX. 

closed earthen pitcher which formerly contained clarified 
butter. A Svitra-patient would do well to take this 
medicine after this period. He should also observe the 
rules of diet and regimen of a Kushtha-patient. The 
application of a Lepa (medicinal plaster), prepared by 
pasting the tender twigs of the Putika^ Arka, Snuhi, 
Aragvadha and of the fdti flower with cow's urine, would 
prove curative in cases of Svitra, ringworm, ulcer, bad 
types of haemorrhoids and sinus. 22-23. 

In case the foregoing medicinal remedies prove 
ineffective, the patient should be duly bled for the 
purpose of letting out the vitiated blood from the 
system, and after sufficiently recouping his strength 
(after blood-betting) his body should be anointed with 
clarified butter. Copious vomitings should be induced 
with the help of strong emetics and the patient should 
be treated subsequently with a judicious administration 
of purgatives (so as to remove the aggravated Doshas 
from the system). The aggravated Doshas of the 
body, not being fully expelled from the organism of 
a Kushtha-patient by means of the preceding emetic 
and purgative measures, tend to extend all over the 
organism and the disease in consequence thereof is sure 
to lapse into one of an incurable type. Hence the 
aggravated Doshas should be fully eliminated from the 
organism. 24-25. 

Emetics should be administered to a Kushtha-patient 
once a fortnight and Sramsana (purgatives) once a 
month. He should be bled twice a year though not 
profusely and medicated snuffs should be administered 
to him every fourth day. 26. 

Internal application of Haritaki^ Trikatu and treacle 

( prepared from the juice of the sugarcane ) mixed with 

oil would lead to the early recovery of a case of Kushtha. 



Chap. IX.] CHIKITSA STHANAM. 357 

As an alternative, he should use a lambative medicinal 
compound of Amalaka, Aksha^ Pippali and Vidanga 
mixed with honey and claiified butter. Or he should 
take a Pala weight of Haridrd with* an adequate quantity 
of cow's urine every day for a month in order to get 
free from Kushtha ; or the same quantity of the fine 
powder of Pippali or of Chitraka should be given ' to 
him through the same vehicle and for the same period 
which would cure him of Kushtha. The same quantity 
of the fine powder of Rasdnjana should be given through 
the said vehicle and in the same manner for a period 
of one month and the same should also be repeatedly 
applied externally. 27-28. 

The bark of Arishta (Nimba) and Sapta-pamiJ^dkshd^ 
Musta, Das'a-muli, Haridrd, Ddj-u-haridrd, Manjishthd, 
A/cs/Mj Vdsaka, Deva ddru, Pathyd^ ChiU-aka Trikati^^ 
Amalaki and Vidanga taken in equal parts and pounded 
together should be mixed with powdered Vidanga^^x^- 
ing as much as the total weight of the preceding drugs ; 
the patient should be made to take a Pala weight of 
this pulverised compound every day (for a month), or he 
should be made to drink (in adequate doses) a Drona 
measure of medicated clarified butter, cooked with the 
powders of Triphald and Trikatu. As an alternative, 
Aksha-pida should be boiled in a Drona measure of 
cow's* urine. Clarified butter, cooked in this pre- 
paration may be used, as a remedy for Kushtha. 
An adequate quantity of old and matured clarified 
butter should be boiled with Aragvadhd.^ Sapta-parna^ 
Patola, Vrikshaka, Naktamdla, Nimba, the two kinds 
of Haridrd and Mushkaka, This medicated Ghrita, 

* Cow's urine and water in equal parts should be taken according to 
some commentators. Dallana, however, recommends cow's urine only and 
no water, 



358 THE SUSHRUTA SAMHITA. [Chap. IX' 

thus prepared, would lead to the destruction of 
Kushtha* 29-30. 

Drugs such as Rodhra,Nimba^ Padma-kdshtha^ Rakta- 
chandana, Sapta-parni, Aksha, Vrikshaka and Vijaka 
should be administered in the bath-]* of the patient in 
the event of there being any burning sensation ; or a 
potion consisting of honey and pasted Tri-bhandi 
(Trivrit) should be given to him. Old and matured 
Mudga, boiled in the decoctionj of Nimha and mixed 
with oil, should be given to the patient as drink where 
sloughing would be detected in the diseased localities. 
A decoction of Nimha or that of Arka, Alarka and 
Sapta-chchhada should be given him if there be any 
worms in the diseased locality. The affected part of 
the body should be plastered over with the roots of the 
As'va-mdra and Vidanga, pasted with cow's urine, in the 
event of its being eaten away by the worms. Cow's urine 
should be sprinkled over the diseased locality and all 
food (of the patient) should be given with the powders 
of Vidanga. 31-32. 

As an alternative, the affected parts should be 
rubbed with the oil of Karanja, mustard, S'igru^ or 
Kos'dmra, or with an oil (any one of the preceding oils) 
cooked with (a decoction of) pungent, bitter and heat- 
producing substances. Measures laid down under the 
head of Dushta-Vrana (malignant ulcer) should be 
resorted to in a case where the aforesaid remedies would 
fail to produce any beneficial effect. 33. 

* Dallana says that the authorship of this remedy should not be attri- 
buted toSus'ruta, inasmuch as Jejjata does not meniion it in his commentary. 

t The drugs are to be boiled in water in which the patient should 
take his bath. 

X The decoction should be prepared in the manrer of **Shadanga» 

Halpa." 



Chap. IX.] CHIKITSA STHANAM. 359 

Vajraka-Taila :— The roots of Sapta-pama, 
Karanja, Arka, Mdlati, Karavira, Snuhi, S'irisha, 
Chitraka and Asphotd as well as of Vis ha (aconite root), 
Ldngala, Vajrdkhya (mica), sulphate of iron, Haritdla^ 
Manah-s'ild Karanja-SQQds, Trikatu, Triphald, the two 
kinds of Haridrd, white mustard-seeds, Vidanga and 
Prapunndda should be pasted together with the urine of 
a cow. The paste thus prepared should be cooked in 
an adequate quantity of oil.* This oil known as the 
Vajraka-Taila, used as uguents, proves remedial to 
Kushtha etc., sinus and malignant ulcers in general. 34. 

IVIaha-Vajraka Taila :~The drugs and sub- 
stances known as white mustard-seeds (Siddhdrthaka), 
the two kinds of Karanja^ the two kinds of Haridrdy 
Rasdnjana^Kutaja^ Prapunndda, Sapta-parna^Mrigddani 
Ldkshdy Sarja-rasa^ Arka, Asphotd, Aragvadha^ Snuhi, 
S'irisha, Tuvara^ Kutaja^ Arushkara, Vacha, Kushtha^ 
Vidanga, Manjishthd, Ldngali, Chitraka, Mdlati, Katu- 
tumbi, Gandhdhvd, Mulaka, Saindhava^ Karavira, Griha- 
dhunia^ Visha (aconite), Kampillaka^ Sindura (mercuric 
oxide), Tejohvd and sulphate of copper should be taken 
in equal parts and made into a paste. This paste 
(Kalka) should be cooked with either Karanja-o\\ or 
mustard-oilf, both of which have great curative potency, 
with double the quantity of cow's urine. It may also be 
prepared with sesamum-oil, but in this case four times as 
much of cow's urine should be taken. As an anointment 
it is undoubtedly efficacious in a case of Kushtha of 
whatsoever type as well as in cases of scrofula, fistula-in- 
ano, sinus and malignant ulcers. This oil is known by the 

* S'ivadasa, the commentator on chakradatta, asserts, on the authority 
of Vagbhata, that the oil should be sesamum-oil and it should be boiled 
with cow's urine. 

t According to Gayaddsa mustard-oil should be used. 



358 THE SUSHRUTA SAMHITA. [Chap. IX- 

thus prepared, would lead to the destruction of 
Kushtha* 29-30. 

Drugs such as Rodhra.Nimba^ Padma-kdshtha^ Rakta- 
chandana, Sapta-parni, Aksha, Vrikshaka and Vijaka 
should be administered in the bathf of the patient in 
the event of there being any burning sensation ; or a 
potion consisting of honey and pasted Tri-hhandi 
(Trivrit) should be given to him. Old and matured 
Mudga, boiled in the decoction| of Nimha and mixed 
with oil, should be given to the patient as drink where 
sloughing would be detected in the diseased localities. 
A decoction of Nimha or that of Arka^ Alarka and 
Sapta-chchhada should be given him if there be any 
worms in the diseased locality. The affected part of 
the body should be plastered over with the roots of the 
As'va-mdra and Vidanga, pasted with cow's urine, in the 
event of its being eaten away by the worms. Cow's urine 
should be sprinkled over the diseased locality and all 
food (of the patient) should be given with the powders 
of Vidanga. Zi-l^. 

As an alternative, the affected parts should be 
rubbed with the oil of Karanja, mustard, S'igru^ or 
Kos'dmra, or with an oil (any one of the preceding oils) 
cooked with (a decoction of) pungent, bitter and heat- 
producing substances. Measures laid down under the 
head of Dushta-Vrana (malignant ulcer) should be 
resorted to in a case where the aforesaid remedies would 
fail to produce any beneficial effect. 33. 

* Dallana says that the authorship of this remedy should not be attri- 
buted toSus'ruta, inasmuch as Jejjata does not mention it in his commentary. 

t The drugs are to be boiled in water in which the patient should 
take his bath. 

X The decoction should be prepared in the manner of *'Shadanga. 
Ualpa." 



Chap. IX.] CHIKITSA STHANAM. 359 

Vajraka-TaJIa :— The roots of Sapta-pama, 
Karanja, Arka, Mdlati^ Karavira^ Snuhi, S'irisha, 
Chitraka and Asphotd as well as of Visha (aconite roc»t), 
Ldngala, Vajrdkhya (mica), sulphate of iron, Haritdla^ 
Manah-s'ild Karanja-seQds^ Trikatu, Triphald, the two 
kinds of Haridrd, white mustard-seeds, Vidanga and 
Prapunndda should be pasted together with the urine of 
a cow. The paste thus prepared should be cooked in 
an adequate quantity of oil.* This oil known as the 
Vajraka-Taila, used as uguents, proves remedial to 
Kushtha etc., sinus and malignant ulcers in general. 34. 

lYIaha-Vajraka Taila :— The drugs and sub- 
stances known as white mustard-seeds (Siddhdrthaka), 
the two kinds of Karanja^ the two kinds of Haridrd^ 
Rasdnjana^Kutaja^ Prapunndda, Sapta-parna^Mrigddani 
Ldkshd, Sarja-rasa, Arka, Asphotd, Aragvadha, Sttuhi, 
S'irisha, Tuvara, Kutaja^ Arushkara, Vacha, Kushtha^ 
Vidanga, Manjishthd, Ldngali, Chitraka, Mdlati, Katu- 
tumbi, Gandhdhvd, Mulaka, Saindhava^ Karavira^ Griha' 
dhunMy Visha (aconite), Kampillaka^ Sindura (mercuric 
oxide), Tejohvd and sulphate of copper shuuld be taken 
in equal parts and made into a paste. This paste 
(Kalka) should be cooked with either Karanja-oW or 
mustard-oil-f, both of which have great curative potency, 
with double the quantity of cow's urine. It may also be 
prepared with sesamum-oil, but in this case four times as 
much of cow's urine should be taken. As an anointment 
it is undoubtedly efficacious in a case of Kushtha of 
whatsoever type as well as in cases of scrofula, fistula-in- 
ano, sinus and malignant ulcers. This oil is known by the 

* S'ivadasa, ihe commentator on chakradatla, asserts, on the authority 
of Vagbhata, that the oil should be sesamum-oil and it should be boiled 
with cow's urine. 

t According to Gayaddsa mustard-oil should be used. 



CHAPTER X. 

Now we shall discourse on the medical treatment 
of major cutaneous affections (IVIahfif-Kushtha).* i. 

Metrical Text :— An intelligent physician 
should have recourse to the following medicinal com- 
pounds in virulent types of Kushtha, urinary com- 
plaints (Meha), diseases due to the action of the de- 
ranged and aggravated Kapha and general cedima of 
the body and also in respect of inordinately corpulent 
persons wishing to reduce their obesity. 2. 

IVIantha-KalpaS : -Pounded barley-corn 
should be saturated with the urine of a cow and kept in 
a large bamboo basket (Kilinj i) for the whole night ; and 
shou'd then bi drieJ in the sun on the following day. 
This process should be continued for seven consecutive 
days. At the close of this period it should be fried in an 
earthen vessel vKapdla) and then ground to fine powder 
(Saktu). The powder, thus prepared should be given 
every morning to a person afflicted with Kushtha 
(leprosy), or any urinary complaint (Prameha) through 
the medium of a decoction of the drugs included 
within the S' alas drddz group, or of the Kantakz {thorny ) f 
trees, and mixed with a pulverised compound of Bhalld- 
taka, Prapunndda, Avalguja, Arka, Chitraka^ Vidanga 
and Musta weighing a fourth part of the S'aktu. Barley- 
corn should, in the same manner, be soaked in a 

* Kushtha which affects the deeper tissues and fundamental principles 
of the body is called Maha-Kushtba. 

Gayi interprets the term " Maha-Kushlha " as signifying those seven 
types of Kushtha which cannot be attributed to any detectable cause, 

t Vadara, Khadira, Arimeda, Snuhi, etc. 



Chap. X.] CHlKlTSA STHANaM. 3,^3 

decoction of the drugs constituting the S' dla-sdrddi or 
\.\mq Aragvadhddi ^XQM'^?,, or barley-corn should be given 
to a cow to eat and the undigested barley-corn passed 
with the cow-dung should be collected. This barley- 
corn should then be fried and powdered in the form of 
Saktu. This powder should be mixed with a pul- 
verised compound of Bhalldtaka^ etc., mentioned above, 
and given to the patient through the medium of a 
decoction of any one of the Khadira^ Asana^ Nimba, 
Rdja- Vriksha, Rohitaka and Guduchi, sweetened with 
honey and sugar, and acidified with grapes, or the ex- 
pressed juice of pomegranate and Amla-vetasa and 
then mixed with rock-salt. This is the method of pre- 
paring all kinds of Manthas. 3. 

Articles of food made of barley-corn in the form 
of Dhana, Lunchaka, Kulmdsha, Apupa, Purnakosa, 
Utkarika,* Sashkulika, Kundrif and Kondli, etc., should 
be given as diet. Preparations of wheat and Venu-yava 
(seeds of bamboo) after the manner of barley prepara- 
tions should also be recommended as a proper 
food. 4-5. 

lYIedicated AriShtas :— Now we shall describe 
the mode of preparing Arishtas (applicable in cases 
of Kushtha). Six Pala weight of each of the following 
drugs, viz., Putika, Chavya, Chiiraka, Deva-ddru^ Sdrivd^ 
Danti diXid Trikatti, 3.r\d one Kudava weight of Vadara 
and Triphald should be powdered. An earthen jar or 
pitcher, which formerly contained clarified butter, should 
be purified]: and plastered inside with a compound 

* Gayadasa reads Chilra (a kind of soup) before " Utkarika.' 

t Dallana does not read *'Konali" but says that some read **Konalika' 

in place of "Kunari" both of which are synonyms. We have, however, 

both the terms in our text. 

X The jar should be purified or disinfected by fumigation with the 

medicinal drugs such as Nimba-leaves, Guggulu, etc. 



364 TriE SUSHRUtA SAMHITA. [Chap. X. 

of honey, clarified butter and powdered Pippali. Then 
the pulverised compound, mentioned above, together 
with seven Kudava measures of water* half a Kudava 
measure of iron-powder, and half a Tuli weight of treacle, 
should be poured into the said jar which should then be 
tightly covered with a lid and placed under a heap of 
barley for seven days (for fermentation). After this 
period, it should be taken out and the patient should be 
made to take some of it (every day) according to his 
physical capacity. This Arishta (fermented liquor) cures 
Kushtha, obesity, urinary complaints (Meha), jaundice 
and cedima. Arishtas may also be similarly perpared 
from the drugs included in the S'dla-sdradi, the Nya- 
grodhddi or the Aragvadhddi group. 6. 

Medicated AsavaS :— Now we shall describe 
the mode of preparing Asavas. The ashes of burnt 
Palds'a should be dissolved in hot water and duly filtered. 
Three parts of this (alkaline) water, subsequently cooled, 
and two parts of Phanita (molasses) should be 
mix^ed together and fermented in the manner of pre- 
paring Arishtat- Asavas may be similarly prepared 
with the alkali made of the ashes of sesamum plants 
(described in connection with the treatment of As'mari 
— Chapter. VII), or with the drugs constituting the S'dla- 
sdrddiy the Nyagrodhddi, or the Aragvadhddi groups, or 
with cow's urine as in the preceeding manner. 7- 

Medicated Suras :— Now we shall describe 
the process of preparing Surds (wines). A decoction 
should be duly made of S'ims'pd and Khadira woods 
with JJttamdrmi^ Brdhmi and Kos'dtaki boiled together 

* Jejjata recommends twenty-eight Pala weight of water, but Gaya^ 
dasa does not support this. 

t Powders of Putika, Chiiraka, etc., mentioned in connection wiih the 
preparation of Arishtas should be likewise added to it, — Dallana. 



Chap. X.] CHIKITSA STHANAM. 365 

in water*. Then Surd-kin va (the dru^ which is used to 
cause the fermentation in the manufacture of spirits) 
should be mixed with the above decoction and the 
compound distilled in the usual officinial method. The 
liquor thus prepared is called Sara'. Suras may be 
similarly prepared, from the drugs of the S' dla-sdrddU 
the Aragvadhadi, or the Nyngrodhddi groups. 8. 

lYIedicated Avalehas (lambatives) —Now 
we shall describe (the method of preparing) medicated 
Avalehas (lambatives). A decoction should be prepared 
with the Sara (essential parts^ oi Khadira, Asana, Nimba, 
Rdfavriksha and S'dla. -f Fine powders of the same 
dru^s should be mixed with the above (decoction) and 
boiled again. The compound should be removed from 
the fire neither thick nor thin. The patient should 
be made to lick a handful I of the compound mixed 
with honey and be made to abstain from taking any meal 
in the morning. Similar preparations may be made 
(Avaleha) from the drugs of the S'dla-sdrddi, the Arag- 
vadhddi, or the Nyngrodhddi groups. 9. 

Medicinal Churnas:-Now we shall de- 
scribe the process of preparing pulverised compounds. 
A Prashtha measure of the powdered Sara of the 
trees belonging to the S'dla-sdrddi group should be 



* One part of S'irns'apa', one of Khadira and a third of Uttamarani, 
Btahnii and Kos'aiaki should be taken. Tula weight of the drugs and 
four Drona measures of water should be boiled and reduced to one Drona. 
— Dallana, 

t Gayalasa does not read *'S'ala" in the list. 

X Though the word "Panitala" means a "Karsha" i.e.y two Tol£s, yet 
as there is the word "Purnam" inserted after it, so a handful should be 
understood here by this term.— Dallana. It should be observed, 
however, that the difference in the two interpretations is uhimaiely 
immaterial. —Ed. 



366 THE SUSHRUTA SAMHITA. [Chap. X. 

many times (i. e,, seven days) saturated with the decoc- 
tion of the drugs of the Arogvadhddi group (and dried). 
Then the prepared compound should be taken with the 

- vehicle of the decoction of the drugs of the said S'dla- 
sdrddi group. A pulverised compound {Churna) may be 
as well prepared in the above manner from the fruits 
of the Nyagrodddhi group or from the flowers of the 
A ragvadhddi group, i o . 
P~~^IYIeClicinaI Ayaskriti : — Nowwe shall de- 
scribe the process of preparing an Ayaskriti (iron com- 
pound). Thin leaves of steel should be plastered with the 
(five officinal kinds of) salts and heated in fire a of dried 
cow-dung. When red-hot, they should be immersed in a 
decoction of Triphald and the drugs of the S' dla-sdrddi 
group. The above process should be repeated sixteen 
times in succession after which they should be heated and 
burnt in a fire of Khadira wood. When cooled down, 
the iron foils should be pounded into fine powder and 
passed through a piece of thick linen. The patient should 
be made to take this powder with honey and clarified 
butter in an adequate dose suiting his capacity. Af;er 

. the digestion of the medicine, he should take such a meal 
as is not hostile to hisparticular disease and is devoid 
of salt and acid articles. The use of a Tula measure 
of this medicinal iron preparation in the above manner 
leads to the recovery of Kushtha, Meha (urinary com- 
plaints), obesity, oedima, jaundice, insanity and epilepsy 
and makes the patient live for one hundred years. The 
use of each additional Tuld weight of the preparation 
adds a century to the duration of the user's life. 
This is the mode of medically preparing all kinds of 
Loha (zinc, copper, lead and gold). 11-12. 

Aushadha Ayaskriti :— A ball of iron 

(weighing fifty Palas) heated and made red-hot in a 



Chap. X.] CHIKITSA STHANAM. 367 

fire of Khadira wood should be cooled by immersing it 
in a cauldran (Droni), made of (green) Palds'a wood 
and containing (five-hundred Palas of) Svarasa (expressed 
juice*yof Trivit, S'y^ma, Agnimantha, Samkhini, Kevuka, 
Lodhra,Triphala, Palas'a and Sims'apA. The iron mass 
should be thus heated and cooled twenty one times 
in succession ; finally the iron ball should be immersed 
and boiled in the expressed juice of the foregoing drugs 
over a fire of cow-dungs. It should be removed from 
the fire when only a quarter part of the liquid would 
remain. It should now be filtered and the mass of 
iron should be again heated in the fire mixed with the 
same liquid and boiled again ; when the cooking is 
nearly complete, (it should be removed from the fire 
and) a pulverised compound of the drugs included in the 
Pippalyddigvow^ together with honey and clarified butter 
each weighing double the quantity of the iron mass or 
ball should be mixed with the same. When cooled down, 
this preparation should be preserved in a well-sealed 
iron-pitcher. The medicine, thus prepared, should be 
given to the patient according to his capacity but not 
less than a Sukti (.half a Pala) or a Prakuncha measure 
(one Pala). After the digestion of this medicine, a diet 
should be given to the patient determined by the nature 
of his disease. This is called the Aushadha Ayaskriti 
and it cures even the incurable types of Kushtha and 
urinary complaints (Meha\ reduces obesity, impairs 
oedima and improves the impaired digestive functions. 

* Old and experienced physicians explain ^'Svaraswu" to be the 
decoction as well. Gaya< asa says that a decoction of one Drona weight 
of the drugs, boiled in four Drona weight of water and reduced to its 
quarter part should be taken. Dallana says that if the expressed juice of 
the drugs be not available, then a cold infusion of one Adhaka weight of 
the powdered drugs should be taken, 



368 THE SUSHRUTA SAMHITA. [Chap. X. 

It is specially efficacious in cases of phthisis 
(Rdja-Yakshmd). A proper and regular use of this 
remedy increases the duration of life to a hundred 
years. 13. 

IVIahaushaclha-Ayaskriti :— A decoction 

of the drugs of the S'dla-sdrddi group should be poured 
in a Droni (vessel) made of Palds'a wood. Sheets of 
iron should be made red-hot and cooled down 
(twenty one times) by immersing them into the said 
decoction of the drugs of the .5 dia-sdrddi group. The 
interior part of an earthen pitcher should be disinfected 
(with' fumigation). Then the iron foils and the powder 
of the drugs of the Pippalyddi group together with 
treacle and honey should be added and preserved 
in the earthen pitcher with its mouth well-covered 
with a lid for a period of one month (in winter) or a 
fortnight (in summer). This preparation is called the 
Mahaushadha-Ayaskriti and an adequate quantity of 
it should be given to the patient after the lapse of the 
said period. Similar preparations of (iron) may be 
made with a decoction of the drugs of the Nyagro- 
dhddi or Arevatddi (Aragvadhddi) group. 14. 

— ^Thc Khadira Vidhana :— Now we shall 

describe the Khadira preparations. The earth around 
the central root of a middle-aged Khadira tree, grown 
in a commendable soil and not worm-eaten, should 
be dug out and the central and principal root of the 
tree should be cut open. An iron pitcher should be 
placed under the tree so that the secreted juice may 
collect into it through the main root. The outer surface 
of the tree should be completely plastered with a 
paste of clay and cow-dung (mixed together). It should 
then be treated with a fire fed with faggots mixed 
with cow-dung so that the glutinous secretions of 



Chap. X.] CHIKITSA STHANAM. 369 

the Khadira tree would naturally settle down into the 
pitcher (through the principal root). When the pitcher 
is filled up, the juice should be collected and 
filtered and then kept in another vessel with its lid 
carefully closed and sealed. The extract so pre- 
served should be taken in proper doses with honey, clari- 
fied butter and the expressed juice of Amalaka. The 
patient should be made to take such diet and observe 
such regimen of conduct, as has been prescribed in 
connection with the use of Bhallaitaka compounds, after 
the digestion of the medicine. A Prastha measure of 
this remedy gradually taken by a man enables him to 
live a hundred summers. 15. 

Khadira-Sara-Kalpa :— A decoction made 

by boiling a Tula weight of the essential part (Sdra)of the 
Khadira tree with a Drona measure of water and boiled 
down to a sixteenth part of its original quantity should 
be kept in a vessel with its mouth tightly closed. 
An adequate quantity of this decoction should be taken 
every day with honey, clarified butter and the expressed 
juice of Amalaka. The present method should be 
adopted with the extract from the essential parts (Sdra) 
of all other medicinal trees. 16. 

Every morning the patient should be made to take 
an adequate dose of the powders of Khadira-satra, 
or its decoction, until a Tula weight is consumed, or 
he should be made to take a potion of the clarified 
butter churned from the milk of a ewe and cooked in 
a decoction of Khadira-sara. As an alternative 
the expressed juice or a decoction of Amrita-valH, or 
clarified butter cooked with that juice or decoction, 
should be taken every morning. The patient should 
every afternoon take a meal of boiled rice with clari- 
fied butter and Amalaka-^ow"^. A constant use of this 

4; 



370 



THE SUSHRUTA SAMHITA. [Chap. X. 



remedy and a conformity to the foregoing diet for a 
month would lead to a radical cure of any type of 
Kushtha. 17. 

Oils pressed out of black sesamum and Bhalldtaka, 
clarified butter, the expressed juice of Amalaka and 
the decoction of the drugs of the S'dla-sdrddi group, 
each weighing a Drona measure, and a Pala weight 
of each of the following drugs, viz., Triphald^ Trikatu, 
the pith or marrow of Parusha fruit, Vidanga seed, 
Chitraka, Arka, Avalguja, Haridrdy Ddru-haridrd^ 
Trivrit, Danti^ Indra-yava, Yashti-madhu, Ativishd, 
Rasdnjana and Priyangu, should be boiled together 
in the manner of cooking medicated oil, etc. (Sneha- 
pdka Vidh^na). When well cooked, this medicated com- 
pound should be strained (through a piece of clean linen) 
and carefully preserved (in an earthen pitcher with its 
mouth well closed with a lid). The system of the patient 
should be well cleansed (with appropriate emetics 
and purgatives) and a Pala weight of this preparation, 
mixed with honey, should be given to him every 
morning. After the digestion of this medicine, he 
should be made to take a light meal of rice well cooked 
with a decoction of the Khadira-wood and mixed with 
clarified butter, and the soup (Yusha) of Amalaka or 
Mudga unseasoned with salt. A Drona measure (of this 
compound), gradually taken in the aforesaid manner by 
a patient taking a (light) decoction* of Khadira (instead 
of water), would ensure a speedy recovery from all 
types of Kushtha and enable the patient to witness a 
hundred summers (on earth) in the full enjoyment of 
sound health and intellect. 18. 

* The decoction of Khadira-wood for drink should be prepared afteir 
the manner of Shadanga-paniya preparation.— Ed. 



Chap. X.] CHIKITSA STHANAM. 37I 

Memorable Verse :— An intelligent physi- 
cian may prepare a thousand varieties of medicated 
remedies, such as Surds, Asavas, Arishtas, Lehas 
(lambatives), powders and Ayaskritis (metal-prepara- 
tions) with the aforesaid drugs and in the manner 
described above. 19. 

Thus ends the tenth Chapter of Chikitsita Sthanam in the Sus'ruta 
Samhitd which deals with the medical treatment of Maha-Kushtha. 



CHAPTER XL 

Now we shall discourse on the medical treatment of 
the diseases of the urinary tracts (Prameha). i. 

This disease may be ascribed to two causes, such 
as the congenital (Sahaja) and that attributable to 
the use of injudicious diet. The first type (Sahaja) 
is due to a defect in the seeds of one's parents and 
the second is originated from the use of unwhole- 
some food. The symptoms, which mark the first 
of these two types, are emaciation and a dryness 
(of the body), diminished capacity of eating, too 
much thirst and restlessness; while the symptoms, which 
usually attend the latter type of the disease, are obesity, 
voracity, gloss of the body, increased soporific tendency 
and inclination for lounging in bed or on cushions. A 
case of emaciation, etc., (viz., the first kind of Prameha) 
should be remedied with nutritious food and drink, etc., 
whereas Apatarpana, etc., (fasting, physical exercise, 
depletory measures etc.), should be adopted in cases of 
obesity viz., the second kind of (Prameha). 2. 

Forbidden Articles of Food & Drink : 

— All patients suffering from Prameha should forego 
the use of (the different species of wine and fermented 
liquor known as) Sauviraka, Tushodaka, Sukta, Maireya, 
Surd, and Asava, water, oil, clarified butter, milk, any 
modification of the expressed juice of sugarcane, cakes, 
milk-curd, acid, Pdnaka* the flesh of domestic and 
aquatic animals and of those which frequent swamps 
or marshy places 3. 

* Made of sugar, lemon-juice, or fermented rice-gruel boiled together. 



Chap. XL] CHIKITSA STHANAM. 373 

Articles of diet:— The use of sufficiently old 
and matured, S'dli and Shashtika rice, barley, wheats 
Kodrava, Udddlaka, with the different preparations of 
Chanaka, Adhaki, Kulattha or Mtidga pulse is recom- 
mended ; or the meal should be taken with the S'dkas 
(potherbs) of bitter or astringent taste cooked with the 
oils of Nikmnbha, Ingudi, mustard or linseed oil ; or 
with the soup of the lean flesh of Jdngala animals 
which are possessed of anti-diuretic properties cooked 
without any clarified butter and unseasoned with any 
acid juice. 4. 

Preliminary Treatment :— -The patient 

should be first anointed with any of the oils (of Nikum- 
bha, Ingudi, Sarshapa, Atasi, etc.); or with the medi- 
cated clarified butter* cooked with the drugs of the 
Priyangvddi group and should also be treated with strong 
emetics and purgatives-f*. After the application of pur- 
gatives, an Asthapana measure with a decoction of the 
drugs of the Surasddi group, mixed with honey and Sain- 
dhava salt and with the powders of S'jinthi, Bhadraddru 
and Musta by way of an after-throw, should be resorted 
to. (On the eighth day) in a case attended with a burn- 
ing sensation, a decoction of the Nyagrodhddi group 
without {i.e , mixed with a little quantity of) Sneha (oil 
or clarified butter) should be used (in the manner of 
an Asthapana). 

The five Medicinal remedies :— After 

cleansing the system, the expressed juicej of 
Amalaka mixed withZ/rtir^'^r^' (powder) and honey should 

* The palient should be anointed with the medicated clarified butter 
in a case of Pittaja-meha. 

t Emetics in cases of Kaphaja-meha and purgatives in those of 
Pittaja-melia, should be applied. 

X This is also found in Charaka and has been quoted by Chakradatta 
in his compilation. 



374 THE SUSHRUTA SAMHITA. [Chap. XL 

be administered. As an alternative, a decoction* of 
Triphald, Vis'dld, Deva-ddru and Musta or an Aksha 
(two Tola) measure of the Kalka (powders^-f- of S'dla, 
Kampillaka and Mushkaka i^both of them) sweetened 
with honey and the expressed juice of Amalaka should 
be taken ; or powders]: of the flowers of Kutaja .Kapittha^ 
Rohita^ Vibhitaka and Saptaparna (should be taken 
with honey, Haridrd and the expressed juice of Amalaka), 
or a decoction of the roots, leaves, barks, flowers and 
fruits of Nimba, Aragvadha^ Saptaparna, Murvd, Kutajay 
Soma-vriksha, P aids a should be given to the patient. 
All cases of Meha are often found to yield to the use of 
any of these five medicinal preparations. 5. 

Specific Treatments :— Now we shall speci- 
fically describe the course of treatment to be adopted 
in each particular type of the disease (Prameha). A 
decoction of Pdrijdta should be given in a case of 
Udaka-meha ; a decoction of Vaijayanti in that of 
Ikshu-meha ; a decoction of Nimba in a case of Surai- 
meha ; a decoction of Chitraka in a case of S'ikatai- 
meha; a decoction of Khadira in a case of S'anair- 
meha; a decoction of Pdthd and Aguru in a 
case of Lavana-melia ; a decoction of Haridrd 

*This is quoted by Chakradalta but he reads «' ^j^f^j " in place 
of " ^ej^jj ^" and does not mention the use of the expressed juice of 
Amalaka. The practice, however, is to follow the recipe of Chakradatla. 

t The third Yoga of the text is also quoted by Chakradatla but no 
addition of Haridra powder is prescribed there. Chakradatla is more 
generally followed in the case. 

X The fourth Yoga of the text is found also in Charaka although wiih 
some variation. Charaka adds the flowers of Kampilla and S'ala in the 
list, but does rot recommend the use of Haridra powder nor of the 
expressed juice of Amalaki as the medium of taking the medicine. 
Charaka, however, is quoted verbatim by Chakradalta and is followed 
in practical use, 



Chap. XI.] CHIKITSA STHANAM. 375 

and Ddru'haridrd in a case of Pishta-meha ; 
a decoction of S'aptaparna in a case of Sandra- 
meha ; a decoction o{ Du7'vdf S'aivdla^ Plava, Hatha- 
karanja and Kas'eruka, or that of Kakubha and red- 
sandal wood in a case of Sukra-meha ; and a decoction 
of Triphald, Aragvadha and Drdkshd mixed with honey 
in a case of a Phena-nieha. All decoctions, to be em- 
ployed in the foregoing ten types of Kaphaja-meha, 
should be sweetened with honey (slightly sweetened with 
honey — D. R ). 

Treatment of Pittaja Prameha : In 

the Pittaja types of the disease, a decoction of the drugs 
of the S'dla-sdrddi group or that of As'vattha should be 
administered in a case of Nila-meha ; similarly a de- 
coction of Rdja-vriksha should be given in a case of 
Haridrat-meha ; a decoction of the Nyagrodhddi group, 
mixed with honey, in a case of Amla-meha ; a decoc- 
tion of Triphld in a case of Ksha'ra-meha ; a decoc- 
tion of Manjishthd and (red) Chandana in a case of 
Manjishthai-meha ; and a decoction of Guduchi, seeds of 
Tinduka, Kds'marya and Kharjura^ mixed with honey, 
in a case of Sonita-meha*. 6. 

Palliative IVIeaSUreS :— Now we shall de- 
scribe the palliative measures to be adopted even in cases 
of incurable types of the disease. A Kalka compound of 
KushtJia^ Kutaja^Pdthd, Hingu diwd Katu-rohini should 
be taken with a decoction of Guduchi and Chitraka in 
a case of Sarpir-meha. A patient afflicted with an 
attack of Vasa(-meha should be made to drink a decoc- 
tion of Agni-mantha or of S'ims'apd. Similarly a decoc- 

• Honey should be added to all oi these decoctions prescribed in 
cases Pittaja-meha. — Dallana. 

t Honey should also be added to these decoctions prescribed in 
cases of Valja Meha — Dallana. 



376 THE SUSHRUTA SAMHITA. [Chap. XI. 

tion o{ Khadira, Kadara and Kramuka should be given 
in a case of Kshaudra-meha ; a decoction of Tinduka, 
Kapittha, S'irisha, Palds'a^ Pdthd^ Murvd^ and Dus- 
parsd (Duraiabh^) mixed with honey * or the Kshara, 
(alkaline water) prepared from the ashes of the bones of 
an elephant, horse, hog, ass or camel, in a case of 
Hasti-meha. A gruel (Yav^gu prepared in the manner 
of Shadanga-kalpa) with a decoction of aquatic bulbs 
and sweetened with milk and the juice of sugarcane 
should be prescribed in a case attended with a burning 
sensation. 7. 

Medicinal Arishtas, Asavas, Yava- 

gUSy etc. : — Likewise Arishtas, Ayaskritis, lamba- 
tives and Asavas should be prepared (in the manner 
hereinbefore described) with Priyangu, A7tantd, Yuthikd, 
Padmd (Bhargi), Trdyantikd, Lohitikd, Amhashthd, bark 
of pomegranate, S' dla-parni, (D.R. — Tala-parni), Padma 
(lotus), Tu7iga, Kes'ura, Dhdtaki, Vakula, S'alntali, 
S' ri'Ves htaka and Mocharasa, should be administered 
to the patient. As an alternative, similar preparations 
made of S'ringdtaka, Gilodya^, Mrindla, Kas'eruka, 
Madhuka, A'mra^ fainbu^ Asana, Tinis'a, Arjuna, Kat- 
vanga^ Lodhra^ Bhalldtaka, Charmi-vriksha, Giri-karnikdy 
S'ita-s'iva, Nichula^ Dddima, Aja-karna, Hari-vriksha, 
Rdjddana,Gopaghontd diwd. Vikamkata should be prescrib- 
ed. Different preparations of Yavagu, etc. should be given 
to the patient as diet. A gruel (Yavagu) cooked with 
the decoction of the preceding medcinal drugs or (only 
these) decoctions should be given to the patient as drinks. 
Potions of any of the aforesaid Asavas thickened 
with an admixture of powdered Pdthd, Chitraka and 
Haritaki and sweetened with a liberal quantity of honey 

* Jejjata interprets it as grape-wine, but Gayadasa does not support 
this view. 



Chap. XL] CHIKITSA STHANAM. 377 

should be prescribed for a rich or royal patient of 
injudicious conduct and refusing to take medicines ; 
or he should be made to drink frequent potions of 
Mddhvika liquors (prepared from honey) * with meat 
roasted on gridiron over a charcoal fire. Food and drinks 
mixed with honey, Kapittha and pepper should be 
prescribed for him. 8. 

The powdered dung of a camel, a mule, or an ass 
should be administered to him in food ; he should take 
his meal with soups saturated with a compound of 
asafoetida and Saindhava salt or with mustard prepara- 
tions (Raga). * His food and drink should be fragrant 
and well flavoured Iwith ingredient not incompatible 
with the nature of the disease. 9-10. 

The practice of regular physical exercise, wrestling, 
active sports, riding on a horse or an elephant, long 
walks, pedestrial journeys, practising archery, casting 
of javelines, etc., should be resorted to in a case where 
the disease has made a decided advance. 11. 

A poor and friendless patient should live on alms, 
lead a life of perfect continence like an ascetic, forego 
the use of shoes and umbrella and walk a hundred 
Yojanasf or more on foot without staying for more than 
one night at a single village. A rich man (suffering 
from Prameha) should live on S'ydmaka, Kapittha, 
Tinduka and As'mantaka and live among the deer. 
He should constantly follow the tracks of cows and take 
their dung and urine (for food and drink). A Brahman 
patient should live on the grain, spontaneously fallen 
from plants, constantly study the Vedas and draw 

* Some read "liT#:" i e. potherb ( of mustard ) in place of 
t A Yojana is ecjual to eight miles. 

48 



373 TttE SUSHRUTA SAMHITA. CChap. XI, 

chariots occupied by Brahmanas. * A patient belong- 
ing to the lower orders of society i^Sudras, etc.) should be 
made to sink wells (under such circumstances) and the 
strength of a weak or emaciated patient should be pre- 
served vwith nutritive diets, etc.). 12. 

IVIemorable Verse :— A poor patient, carefully 
following these directions of his medical advisers 
without the least demur or delay, should be able to get 
rid of the disease (Prameha) in the course of a year or 
even in less than that time. 13. 

Thus ends the eleventh Chapter of the Chikitsifa Sthanam in the 
Sus'ruta Samhita which deals with the medical treatment of Prameha, 



* Some explain the phrase "^HT^q^^Urf" to mean that he 
should retain in his memory (the teachings of) the Vedas.. —Dallana. 



CHAPTER XIL 

Now we shall discourse on the medical treatment of 
the abscesses or eruptions which mark the sequel of a 
case of Prameha (Pramcha-PiClakgf). i. 

The nine kinds of abscesses (Pidakas), such as 
Sardvika, etc., have been described before. Of such 
abscesses those, appearing in a strong person but 
small in size, affecting (only) the Tvak (skin) and the 
flesh, soft to the touch, slightly painful, easily suppura- 
tive and after a time bursting, are curable. 2. 

Patients suffering from Prameha and afflicted with 
the above kinds of abscesses (Pidakas) should be 
treated (in the following manner). Measures, such as 
fastings (Apatarpana), etc., decoctions* (of Vata, etc.) 
and the urine of a she-goat, should be employed in the 
incubative stage of the disease. The urine, perspira- 
tion and the Sleshma (sputum, etc.), soon acquire a 
sweetish taste, if the aforesaid preliminary measures 
are not resorted to and if the patient goes on using sweet 
articles of food in utter disregard of the instructions, 
thus developing fully the specific indications of Pra- 
meha. In this stage the system of the patient should 
be cleansed (Sams'odhana) with both emetics and 
purgatives. If the disease is not checked (even at 
this stage) with the aforesaid measures (emetics and 
purgatives), the aggravated Doshas of the body go on 
increasing in intensity and tend to affect or vitiate the 
flesh and the blood and produce an inflamatory swelling 
of the body, or bring on other supervening distresses 

* Astringent drugs of fig»tree(Vata-tree), etc.— D. R. 



38o THE SUSHRUTA SAMHITA. [Chap. XII. 

in their train, venesection as well as the aforesaid 
remedies and measures should be resorted to in such 
cases. 3 . 

The swelling increases in size attended with exces- 
sive pain and burning sensation, if the aforesaid remedies 
be not employed at this stage of the disease. Surgical 
operations and other remedial measures, described in 
connection with abscesses or inflammatory swellings 
(Vrana) in general, should be resorted to in such cases. 
If these be not done (at this stage), the pus eats into 
the deeper tissues of the locality, creates large cavities 
in its inside, and is accumulated there and the abscess 
(Vrana) becomes incurable. * Hence a case of Prameha 
should be remedied at its very outset. 4-6. 

DhsCnvantara-Ghrita :— Ten Pala weight of 

each of these drugs, viz,^ Bhalldtaka^ Vilva, Ambu, roots 
of Pippaliy Ddakiryyd, Prakiryyd'\, Varshdbhu, Punar- 
navdlt Chitraka^ S'athi, Snuhi, Varunaka^ Pushkara^ 
Danti and Haritaki and one Prastha measure of each 
of the following, viz., barley, Kola and Kulattha pulse 
should be boiled with a Drona measure of water. The 
decoction should be boiled down to its quarter part, 
removed from the fire, and strained. It should then be 
cooked with a Prastha measure (four seers) of clarified 
butter with half a Pala weight of each of the following 
drugs, viz.f Vachd, Trivrit^ Kampilla^ Bhdrgi^ Nichula, 
S'unthiy Gaja-Pippaliy Vidanga and S'irisha as Kalka. 

* On the failure of the above treatment it would spontaneously burst 
out and secrete pus and force its way inside, which would lead gradually 
to widen its mouth or fissure, and help its running into an incuvable 
stage. — Dallana. 

t **Udakiry^ and Prakiryd" are the two kinds of Karanja. 

X "Varshabhu and Punarnava" are the two kinds of Punarnava 
(/.tf., red and white). 



Chap. XII.] CHIKITSA STHANAM. 38I 

It is called the Dhatnvantara-Ghrita* and covers within 
the range of its therapeutic application Meha (urinary 
diseases), swelling, (S'otha), Kushtha, Gulma, Ascites, 
haemorrhoids, enlargement of the spleen, carbuncles 
(Pidaka) and abscesses. 7. 

Ordinary purgatives fail to produce any satisfactory 
effect in cases of Madhu-Meha owing to the excessive 
accumulation and pervasion of Medas (fat) in the or- 
ganism of the patient. Hence strong Sodhana (pur- 
gatives) should be employed in such cases. In all types 
of Meha, attended with PidakSL (eruptions or abscesses) 
and other complications, the perspiration and expectora- 
tions, etc. of a Prameha-patient acquire a sweet taste 
and smell like that of honey. Hence they are techni- 
cally known as Madhu-Meha (to all intents and pur- 
poses . romentation (of any kind) is forbidden in the 
case of a patient suffering from Madhu-Meha, since it 
might lead to the gradual emaciation of his frame by 
drying up the organic fat (Medas), which is usually 
found to abound in his organism. The aggravated Doshas 
of the body fail to make an upward passage in the 
organism of a Prameha-patient, owing to the weakness 
of the channels of chyle, blood, Kapha and Pitta (as 
well as for an exhausted condition of the nerves in his 
body) and the Doshas are thus forced to course in and 
confine themselves into the lower part of the body where 
their incarceration helps the easy formation of Pidakais 
(abscesses), etc. Such a Pidaka should be remedied with 
the measures described in connection with Vranas, as 
soon as the process of suppuration would set in; whereas 

* According to Dallana, the introduction of this medicated Ghrila 
into the text is an interpolation. Since Jejjata has ftot explained it in his 
commentary, Dallana does not explain it. Chakradatta, however, 
mentions this Ghrita in his compilation, though with some additions and 
alterations under the treatment of Prameha.— Ed. 



382 THE SUSHRUTA SAMIllTA. [C^hap. Xtt. 

it should be treated as a swelling in its unsuppurated 
stage. Medicated oils should be likewise employed 
for the purposes of healing (Ropana), etc. 8. 

A decoction of the drugs of the Aragvadhddi group 
should be used for the purpose of raising up (Utsadana) 
the cavity of the incidental ulcer \ that of the S'ala-sara'di 
group should be used for sprinkling purposes ; that of the 
drugs of the Pippalyddigrow^ should be given as food 
and drinks. A pulverised compound o{ Pdthd, Chitraka, 
S'drmgashtd, Kshudra, VriJiati, S*drivd Soma-valka^ 
Saptaparnay Aragvadha and Kutaja roots mixed with 
honey should be internally given to the patient. 

S'ala-saradi Avaleha :— A decoction of (one 

hundred Pala weight of) the drugs of the S'dla-sdrddi 
group should be made by boiling it (in sixteen times the 
weight of water) down to a quarter part (of the water) and 
then duly filtered (through a piece of linen). It should 
be cooked again very carefully, so that it may not be 
burnt; powders of Amalakaf Rodhra, Priyamgu^ Danti, 
black-iron and copper should then be added to it just 
before the completion of the cooking, so that it may be 
reduced to the consistency of an Avalcha (lambative). 
It should then be removed from the fire and kept in a 
closed earthen pitcher. The patient should take an 
adequate dose of this medicine as it is a sovereign re- 
medy for all types of Prameha. 9. 

Navayasa-Churna :•— Equal parts of the 

powders of the following nine drugs, viz., Triphald, 
Chitraka^ Trikatu^ Vidanga and Musta^ and nine parts 

* Chakradatta reads '* S'ivd " in place of "Amalaka" and does not 
include " Priyamgu " in the list. According to some commentators the 
total weight of the after-throw (Prakshepa) would be a quarter part of the 
total weight of the drugs boiled ; whereas, according to others, the 
different drugs for Prakshepa would weigh one Pala each. 



Chap. XII.] CHIKITSA STHANAM. 383 

of powdered black- iron* should be mixed together and 
taken in adequate doses with honey and clarified butter. 
This is called the Navayasa Churna, which proves 
curative in abdominal obesity, improves the impaired 
digestion and acts as a prophylactic against haemor- 
rhoids, swelling, jaundice, Kushtha, indigestion, cough, 
asthma and Prameha, etc. 10. 

LohariShta :— A decoction of the drugs of the 
S'ald-sdrddi group should be made by boiling it down 
to a quarter part (of the original quantity of water). 
Then it should be duly filtered j when cooled, a quantity 
[i.e., fifty Pala weight) of Makshika-honeyt should be 
added to it. A quantity of purified treaclej reduced to 
the consistency of Phanita as well as fine powders of 
the. drugs of the Pippalyddi group should be mixed with 
it. A strong and well cleansed (earthen) pitcher satu- 

* Charaka and Chakrapani Datta insert this medicine among the 
curatives of " Pa'ndu-roga ". S'ivadasa (the commentator) advises to 
take " Manduia-iron" instead of " black-iron ". In the practical field 
also we derive great and good efTects in cases of spleen and liver diseases 
and specially in cases of infantile liver and heart diseases. — Ed. 

t Dallana says that fifty Pala weight of each of the two substances — 
Madhva'sava and Pha'nita, and twenty-five Pala weight of each of the 
following substances., viz., the powders of the drugs of the Pippalyadi 
group and steel-foils, should be taken in preparing it. But Gayadasa 
explains that such a quanlity of old and matured honey should be mixed 
with the decoction as will sweeten it ; the same quantity of old and 
matured Phanita treacle should be taken ; the powders of Pippalyadi 
group should be added to it till it gets a slight astringent (Katuka) 
taste. 

Some commentators, however, hold that the honey, the powders of the 
drugs of the Pippalyadi group and of the steel-foils should be each a 
quarter part of the decoction in weight. 

Dallana explains the term "Madhu" as the A'sava prepared of 
honey. Gayadasa, however, explains it simply as honey. 

t The Phanita should be refined by dissolving it in the decoction of 
the drugs of the S'ala-saradi group and then filtere . — Dajlan^, 



384 THE SUSHRUTA SAMHITA. [Chap. XII. 

rated with clarified butter should be purified (in the 
usual way) and its interior plastered with coating of 
honey and powdered Pippali made into a thin paste. 
The medicinal compound prepared as above should be 
kept in the pitcher. After that, thin foils of steel made 
red-hot in a fire of Khadira wood should be immersed 
into the compound prepared before. Then the pitcher 
with the steel-foils immersed into its contents should be 
kept buried in a heap of barley for three or four months 
or until the steel-foils are entirely eaten away by the 
medicine and the characteristic flavour is produced. It 
should be used in proper doses every morning and a 
suitable diet should be given to the patient after its use. 
It reduces fat, improves the impaired digestion and 
proves efficacious in cases of swellings, internal tumours, 
Kushtha,Meha, jaundice, dropsy of the spleen (Plihodara), 
chronic fever, and excessive urination (dribbling of 
urine). This preparation is called Loha^rishta* and it is 
a highly efficacious remedy. 11. 



* The recipe of Loharishta, according to Vagbhata, is as follows : — 
The drugs of the Asanadi group (which corresponds with Sus'ruta's 
S'ala-saradi group), each weighing twenty Palas, should be boiled in eight 
Dronas of water down to a quarter part of its weight. Two hundred Pala 
weight of treacle and half an Adhaka (four seers) of honey and the powders 
of the drugs of the Vatsakadi group (which corresponds with the Pippa- 
lya'di group of Sus'ruta), each weighing one Pala, should be mixed 
with the abovei decoction when cooled. A (new earthen) pitcher should 
be plastered inside with (an adequate quantity of) Pippali-powder and 
honey, the outer side being plastered with shellac. The above prepara- 
tion should now be poured into this pitcher which should be kept in a 
heap of barley. A fire should be kindled with Khadira charcoal. Thin 
iron-foils should be alternately heated in this fire and immersed in the 
above preparation until the iron- foils are powdered. Vagbhata gives 
the name of Ayaskriti to this preparation. 

We, however, follow Vagbhata in the preparation of this Arishta with 
pood results.. — Ed, 



Chap. XII.] CHIKITSA STHANAM. 385 

Traits of cure : -The cure of Prameha-patients 
should be understood from the non-slimy and unturbid 
condition of the urine and from its clear transparent 
aspect and bitter or pungent taste. 12. 

Thus ends the twelfth Chapter of the Chikitsita Sthanam in the Sus'ruta 
Sambita which deals with the medical treatment of Prameha-Pidaka. 



49 



CHAPTER XIII. 

Now we shall discourse on the medical treatment 

of Diabetes (IVIadhu-IVIeha). I. 

IVIetrical Text :— The intelligent physician 
should adopt the following course of treatment in the 
case of a Madhu-Meha-patient abandoned as incurable 
by other physicians. 2. 

^i lajatu , its origi n and properties :~ 

A kind of gelatinous substance is secreted from the sides 
of the mountains when they have become heated by the 
rays of the sun in the months of Jyaishtha and Ashadha. 
This substance is what is known as the Silajatu and it 
cures all distempers of the body. 

The presence of the six kinds of metal, such as tin, 
lead, copper, silver, gold and black-iron, in their essen- 
tial form in the substance (Silajatu), may be 
detected by their respective smell and hence it is 
known to the people by the name of Shad-Yoni 
(lit. — having six different origins). The taste of 
this shellac-coloured substance has the same taste 
(Rasa) and potency (Virya) as the metal to whose 
essence it owes its origin. It should be understood that 
as tin, lead and iron, etc., are progressively more and 
more efficacious, so the different varieties of Sildjatu, ori- 
ginated from the essence of tin, lead, iron, etc., are pro- 
gressively more efficacious in their application. 

All kinds of Silajatu have a bitter and pungent 
taste with an astringent after-taste (Anu-rasa), are 
laxative, pungent in their digestionary reaction, heat- 
making in their potency and possessed of absorbing and 
purifying (Chhedana) properties. Of these what looks 



Chap. XIII.] CHIKITSA STHANAM. 387 

black and glossy, is heavy and devoid of sandy particles, 
as well as what smells like the urine of a cow, should 
be considered as the best. This best kind of Sildjatu 
should be infused with the decoction of the drugs of 
the ^dla-sdrddi group after the manner of Bhavana 
saturation (for ten, twenty or thirty days). Then after 
cleansing the body (by the application of emetics and 
purgatives), it should be taken every morning (by the 
patient in adequate doses), well pasted with Sdrodaka.* 
He should further be made to take a meal of boiled 
rice mixed with the soup of the flesh of animals of 
the Jangala group after the medicine had been fully 
digested. 3-4. 

A Tuld measure of this hill-begotten panacea 
(Sildjatu), when gradually taken, (in adequade doses) 
tends to improve the strength and complexion of 
the body, cures an attack of Madhu-Meha and 
enables the user to witness a hundred summers on 
earth, free from disease and decay. Each Tula 
weight of this medicine, taken successively, adds a 
century to the duration of human life, while ten Tuld 
measures extend it to a thousand years. The regimen 
of diet and conduct during the period of its use should 
be identical with that described in connection with the 
use of the Bhallaitaka compounds. Cases of Meha, Kush- 
tha, epilepsy (Apasmara), insanity, elephantiasis, poison- 
begotten distempers, phthisis, aedema, haemorrhoids, 
Gulma (internal tumours), jaundice and chronic fever, 
prove readily amenable to the curative efficacy of 
Silajatu. Indeed there is no such bodily distemper 

* It is evident from the reading of Chakradatta that "S^rodaka" 
means a decoction of the drugs of the ^sCla-S££rs£di group. But Dallana 
explains it as "Pancha-sarodaka" which is quite unintelligible. In 
practice, also, Chakradatta is followed.— Ed, 



3^8 THE SUSHRUTA SAMHITA. CChap. XlII. 

which does not yield to its highly curative virtues. It 
acts as a potent solvent in cases of long-standing Sarkari 
(gravel) in the bladder as well as of stone. Sildjatu 
should be treated (soaked and dried) with appropriate 
medicinal drugs by stirring it up with the same. 5. 

The MakShika Kalpa:— The metal known 
as Ms^kshika (iron-pyrites), which grows in the river 
Tapi and which copes with the divine ambrosia in its 
highly therapeutic properties, may be also used in the 
same way and under the same sort of preparation. 
The metal is divided into two classes according to 
its colour, as Svarna-Makshika (gold-coloured) and 
Rajata-Makshika (silver-coloured). Of these the first has 
a sweet taste while the second is acid. Both of them 
prove efficacious in cases of decrepitude, Kushtha, Meha, 
jaundice and consumption. A person using SiMjatu 
and Mdkshika (in the manner prescribed above) should 
refrain from taking pigeon-flesh and Kulattha pulse 
(during his life-time). 6. 

The following measures should be adopted by an 
experienced physician in the case of a patient suffering 
from (Meha and) Kushtha and who has a firm faith in 
medicines and is desirous of existence (life) and in 
whose case the curative efficacy of Pancha-karma* has 
been baffled. 7. 

The Tu varaka Kal pa : —The Tuvaraka plants 
which grow on the shores of the Western Sea 
(Arabian Sea) are constantly tossed about by the winds 
raised by the waves of the sea. The pith or marrow 
of the seeds (lit.— fruits) of these plants should be care- 

* Some take the term in its ordinary sense to mean the five measures 
of emetics, purgatives, etc. ; but Dallana would explain it as the measures 
adopted in the treatment of the Kushtha affecting the bcJne which is the 
fifth Dhatu in the system. 



Chap. Xni.] CHIKITSA STHANAM. 389 

fully collected in the rainy season while they ripen and 
should be subsequenly dried and pounded. The oil 
should be either pressed out of these seeds in a mill in 
the manner of preparing sesamum oil, or squeezed out 
(of a press bag) like that used in the case of Kusumhha 
flowers. The oil should be boiled over a fire so as to 
have its inherent watery particles completely evaporated. 
Then it should be taken down from the fire and kept in 
a pitcher and then buried for a fortnight in a heap of 
well dried cowdung. The patient (in the meantime) 
should be duly anointed, fomented and treated with 
cleansing remedies \^i.e., emetics and purgatives).* He 
should wait a fortnight (after the administration of 
the aforesaid measures) and wait for a period of 
four mealsf (i.e., two days) more ; and on the next 
morning he should drink a portion of the oil in ade- 
quate doses (two Tolds) under the auspices of favourable 
astral combinations in the lighted fortnight of the month. 
He should be made to recite, at the time of his taking 
the fourth dose, a Mantra which runs as follows : — 
"Cleansest and purifiest, O Thou potent essence of seed- 
marrow, all the essential principles of (my) vital organism. 
The deity who knows no decay and suffers no change and 
who weilds a discus, a mace and a conch-shell in his 
arms, commands thee on that behalf." 

The Doshas in both the upper and the lower parts of 
a patient's body are cleansed with the help of this oil 

* The Kapha should be first reduced with emetics ; and after a 
fortnight, the Pitta with purgatives. A fortnight after the use of purgatives, 
a potion of the Tuvarka oil should be administered inasmuch as it is a 
Sams'odhaka (cleansing) remedy 

t On the sixteenth day after the administration of the cleansing mea- 
sures, as well as on the morning of the seventeenth day, the patient should 
take his meals as usual. On the evening of the seventeenth day no meal 
should be taken. On the following morning the oil should be taken. 



390 THE SUSHRUTA SAMHITA. [Chap. XIII. 

(which should be given to the patient in the morning) ; 
while a cold gruel, unseasoned* with salt and not mixed 
with any emollient substance (oil or clarified butter) 
should be given to him in the afternoon. The use of this 
oil should be repeated in the same manner for five days 
in succession, and the patient should avoid anger, 
etc., and live on Mudga soup (Yusha) and boiled rice for 
a fortnight. A five days' use of this oil would ensure 
the cure of every types of Kushtha (and Madhu- 
meha). 8-9. 

The foregoing (Tuvaraka) oil should be boiled and 
prepared with a decoction of Khadira weighing three 
times the quantity of the oil and taken internally with 
patience for a month for the same purpose. The patient 
should anoint his body with the same and then take his 
meals in the prescribed form. A Kushtha-patient (as 
well as a Meha-patient) suffering from hoarseness, red- 
eyes and with worm-eaten and emaciated limbs should 
be speedily treated with this oil as an anointment and 
a drink. Regular potions of the above medicinal (Tuva- 
raka) oil taken with honey, clarified butter and a 
decoction of Khadira and a diet consisting of the soups 
of bird's flesh (during its course) would enable the user 
to live for a period of two hundred years. A use of this 
oil as errhines (Nasya) for a period of fifty consecutive 
days would enable the user to witness three hundred 
years on earth, in the full enjoyment of bodily vigour 
and a youthful glow of complexion, as well as with a 
very powerful retentive memory. 

A regular use (in an adequate dose) of the pith 
of Tuvaraka cleanses the system of the patient 
and is a most potent remedy in cases of Kushtha 
and Meha. 10. 

* A little quantily of sail and of oil or clarified butter may be given. 



Chap. XIII.] CHIKITSA STHANAM. 39I 

The pith (inner pulp of the seeds^ of the Tuvaraka 
burnt in a closed vessel (Antar-dhuma) should be mixed 
with Saindhava-salt, Anjano^ and Tuvaraka oil. This 
prepared compound, used as a coUyrium, is efficacious in 
cases of eye-diseases, such as night-blindness, Arman, 
Nili, Kdcha-roga (dimness of sight) and Timira. 11. 

Thus ends the thirteenth Chapter of the Chikitsita Sthanam in the 
Sus'ruta Samhita which deals with the treatment of Madhu-Meha. 

* Dallana recommends the three thing?, viz., the pith of the Tuvaraka, 
the Saindhava-salt and the Rasanjana to be mixed and burnt together in a 
closed vessel. 



CHAPTEE XIV. 

Now we shall discourse on the medical treatment of 
dropsy with an abnormal condition of the abdomen 

(Udara). i. 

Of the eight different types of Udara, described be- 
fore, those severally known as the Vaddha-guda and the 
Parisrdvi should be understood as incurable, the rest being 
equally hard to cure. Hence the medical treatment of all 
cases of Udara (abdominal dropsy) should be resorted to 
without holding out any positive hope of recovery. The 
first four types of the disease (as metioned in the list of 
enumeration), may prove amenable to medicine ; but the 
rest would require Surgical treatment. All the types of 
the disease, however, would, with the progress of time, 
require a surgical operation, or (attaining an incurable 
stage) they may have to be abondned. 2. 

Diet of articles forbidden :— A patient, 

afflicted with an attack of Udara, should forego the use 
of heavy (indigestible), or emollient fare, of all kinds 
of meats and of those that produce a state of extreme 
dryness in the system, or produce a slimy secretion from 
the channels (of the Doshas and the vital principles) of 
the body, or give rise to a sort of digestionary acid 
reaction (acid transformation in the stomach) and re- 
frain from bathing and using effusions. Meals consisting 
of well cooked S'dli rice, barley, wheat, or Nivdra seeds 
should be the daily diet of such a patient. 3. 

Treatment of the Vsitaja type :-ln a 

case of Vdtaja Udara, the body of the patient should be 
anointed with clarified butter cooked with the drugs of 
t;he Viddri'gandhddi group, while the one cooked with 



Chap. XIV.] CHIKITSA STHANAM. 393 

Tilvaka should be used as purgatives (Anuloma), A 
compound made of a copious quantity of oil of 
Chitrd seeds, mixed with a decoction of the drugs of the 
Viddri-gandhddi group, should be used as Asthapana 
and Anuvasana measures. The Sailvana Upansiha 
(poultice) should be applied to the abdomen. Milk 
cooked with the drugs of the Viddri-gandhddi group, 
or the soup of the flesh of Jdngala animals should be 
given to the patient with his meal and the affected 
region should be frequently fomented. 4. 

Treatment of the Pittaja Type :— In 

a case of Pittaja Udara, the patient should be anointed 
with clarified butter cooked with the drugs of the 
Madhura (Kdkoly^di) group. Similarly, clarified butter 
cooked with S'ydmd, Jriphald and Trivrit should be 
used as purgatives and the decoction of the drugs of the 
Nyagrodhddi group, mixed with a copious quantity of 
sugar, honey and clarified butter, should be used as 
Anuvasana and A'sthdpana measures. The abdomen 
should be poulticed with Payasa (porridge prepared with 
rice and milk) and the diet should consist of boiled rice 
and milk, cooked with the drugs of the Viddri-gandhddi 
group. 5. 

Treatment of the'Kaphaja Type :— In 

a case of Kaphaja Udara, the patient should be anointed 
with clarified butter, cooked with the decoction of the 
drugs of the Pippalyddi group. Likewise, clarified 
butter, cooked with the milky juice of Snuhi plants, 
should be used as purgatives ; and the decoction of the 
drugs of the Mushkakddi group, with a copious quantity 
of Trikatu^ cow's urine, Kshdra (Yava-kshara) and oil, 
should be applied as Anuvasana and Asthapana 
measures. A poultice (Upandha) prepared of S'ana 
seeds, Atasi seeds, DhdUiki (flower), mustard, Mulaka 

50 



394 THE SySHRUTA SAMHITA. [Cbap. XIV. 

seeds and Kinva should be applied (hot) to the ab- 
domen. The diet should consist of (boiled rice well- 
mixed with) Kulattha soup (Yusha), profusely seasoned 
with powdered Trikatu, or of Payasa ; and the abdomen 
should be frequently fomented. 6. 

Treatment of Dushyodara :— in a case 

of Dushyodara, the patient should be treated without 
giving any hope of a positive cure. Purgatives with 
clarified butter, cooked with the expressed juice of 
the Saptald and S'amkhini, should be first administered 
(continuously) for a fortnight or even a month ; or clari- 
fied butter, cooked with the milky juice of the Mahd- 
vriksha^ and with wine and cow's urine, should be simi- 
larly used as a purgative. A Kalka made up of the roots 
of the As'vanidraka, Gunjd and Kdkddani mixed with 
wine (Sura), should be given after the bowels had begun 
to move freely. As an alternative, a Krishna- Sarpa (black 
lance-hooded cobra) should be enraged to bite a sugarcane 
and this piece of sugarcane should be given to the patient 
to chew (and suck) ; or the fruits of creepers (Valli-phala) 
should be used (in the preceding manner) ; or poisonous* 
roots and bulbs should be prescribed, whereby the 
disease may be cured or may take a different turn. 7. 

IVIemorable Verse:— A case of abdominal 

dropsy (Udara) of whatsoever type should be presumed 
to have its origin in an' aggravation of the bodily 
Vdyu and an accumulation of faecal matter in the 
bowels ; hence frequent use of Anulomana (purgatives, 
etc.) is recommended in this disease. 8, 

* If this be not done, the patient is sure to die j but it is not certain 
whether he would get any relief from this treatment. It being, however, 
possible in some cases to save the life of a patient by the application 
of this medicine, it should be used, as the last resort with the permission 
of the king.^Dallana. 



Chap. XIV.] CHIKITSA STHANAM. 395 

General Treatment :— Now we shall 

describe a few general medicinal compounds (which may 
be used with advantage in cases of Udara). They are as 
follows ; — Castor oil with milk or with the urine of a cow 
should be taken for a month or two. No water should 
be taken during the period, or the patient should forego 
the use, of water and all other food, but drink only the 
urine of a she-buffalo and (cow's) milk ; * or he should 
live upon the milk of a she-camel alone, foregoing the 
use of rice and water and submit himself to a course of 
Pippali for one month in the manner described before 
(under the treatment of Mahd-Vatavyddhi),-|* or take the 
oil of the Nikumbha with Saindhava-salt and powdered 
Ajamodd dissolved in it. The said oil (of Nikumbha), 
cooked with a hundred Pdtra weight of the expressed 
juice of A'rdraka and S'ringavera (fresh ginger), should be 
applied in the event of there being any Sula (colic pain), 
due to the action of the deranged and aggravated Vdyu. 
Milk, boiled with the expressed juice of S'ringavera 
(fresh ginger), should be taken. A paste-compound of 
Chavya and S'ringavera, or a paste-compound of Sarala^ 
Deva-ddru and Chitraka (with milk), or a paste-com- 
pound of Murangi, S'dlaparni, S'ydmd and Punarnavd 
(with milk), or the oil of Joytishka seed, mixed with 
milk, Svarjikd and Asafoetida, should be administered 
to the patient. 9. 

He should take Haritaki with treacle, or a thousand 
Pippali soaked (twenty one times) with the milky juice 
of the Snuhi plant \ys\ the manner of Bhavand saturation), 
should be gradually consumed. Powdered Pippali and 

* The milk here, says Dallana on the authority of Jejjata, should be 
buffalo's milk. But, according to Vagbhata and S'ivadasa, the commen- 
tator of Chakradatta, cow's milk should be used.— Ed. 

t The Pippalis shohld be taken with milk only in the present instance, 



396 THE SUSHRUTA SAMHITA. [Chap. XIV. 

Haritaki should be soaked with the milky juice of the 
Snuhi plant (and dried in the sun). Utkarika should 
now be preapared with this compound and given to the 
patient. lo. 

The Haritaki Ghrita:--A Prastha mea- 
sure of powdered Haritaki should be mixed with an 
Adhaka measure of clarified butter and heated over a char- 
coal fire by stirring it up quickly with a ladle ; when well 
mixed, the compound should be poured into an earthen 
pitcher, which should be kept well corked and buried 
in a heap of barley for a fortnight. The pitcher should 
then be taken out and the compound should be 
strained and cooked again with an adequate * quantity 
of the decoction of Haritaki, Kdnjika (fermented 
rice-gruel) and curd. The patient should use this medi- 
cine for a month or a fortnight in proper doses and 
with adequate vehicles, ii. 

The MahaL-vriksha Ghrita:— A quantity 

of the milky juice (one fourth of the cow's milk in quanti- 
ty) of the Mahd-vriksha (Snuhi plant), should be boiled 
with cow's milk. Then it should be removed from the oven, 
cooled down and churned (with a churning rod). The 
butter thus prepared and cooked again with the milky 
exudations of the Mahd-vriksha (and an adequate 
quantity of water) should be given to the patient for 
a month or a fortnight in adequate doses and with 
proper vehicles. 12. 

The Chavy^di Ghrita :— Half aKarsha (one 
Tola) measure of each of the following drugs,z'2>., Chavya, 
Chitraka^ Danti, Ativishd, Haridrd, S'amkhiniy Trivrit 
and Trikatu, together with an eight Karsha measure of 
the inner pulps of the fruit (seeds) of the Rdja-vriksha, 

* Each of the three things (liquids) should be four times as much ag 
the clarified butter. 



Chap. XIV.] CHIKITSA STHANAM. 397 

two Pala weight of the milky juice of the Mahd-vriksha^ 
eight Pala weight of cow's milk and eight Pala weight of 
cow's urine, shpuld be cooked* with a Prastha measure 
(four seers) of clarified butter. The medicated Ghrita, thus 
prepared, should be given in convenient doses to the 
patient for the period of a month or a fortnight. 13. 

The aforesaid three Ghritas (Haritaki-Ghrita, Mahd- 
vrlksha-Ghrita and Chavyddi-Ghrita) and the Tilvaka- 
Ghrita (mentioned in the chapter dealing with Vdta- 
vyddi) should be employed, whenever purgatives would 
be necessary in cases of Udara, internal tumour (Gulma), 
abscess, AshthiU, Anaha, Kushtha, insanity and 
epilepsy. 14. 

Constant use of (cow's) urine or (any kind of) Asava, 
Arishta or wine, cooked with the milky exudation of 
Mahd-vrikshd, -j* is recommended. A decoction of 
purgative drugs, thickened with an admixture, in 
copious quantity, of powdered S'unthi and Deva-ddru, 
may be used with advantage in this desease. 

AnSlha Varti:— APala weight of the emetic 
and purgative drugs and the same weight of the fine 
powders of the drugs of each of the Vachddi^ Pippalyddi 
and the Haridrddi group, and all the officinal kinds of 
salt should be mixed (with four or eight times that of) the 
urine (of a cow, buffalo, etc.). Then this (^mixture) com- 
pound should be boiled and cooked over a gentle fire with 
a Prastha measure of the milky juice of Mahd-vriksha 

* In the absence of any mention about the quantity of water to be 
added, four limes as much of water should be added for the completion of 
the preparation according to the general maxim. — Ed. 

t Dallana explains the sentence as follows : — 

Asavas, Arishtas and Suras should be prepared with urine (instead of 
the liquid i.e., water) and the milky exudation of Maha-vriksha (as ap 
after-throw), and should be constantly used. 



398 THE SUSHRUTA SAMHITA. [Chap. XIV. 

by constantly stirring it with a ladle. Precaution should 
be taken so that the Kalkas may not be scorched 
or burnt. This medicinal compound, when properly 
prepared, should be removed from the fire and when 
cooled should then be made into pills (Gutika), each 
being an Aksha (two Tolds) in weight. These pills 
should be given once, twice or thrice daily according to 
the exigency of the case and the capacity of the patient 
for a period of three or four consecutive months. The 
medicine is known as the Anaiha-varti, and is specially 
beneficial in cases of Mahd-vyddhi, and is equally 
efficacious in destroying intestinal worms. These 
pills, if regularly used, prove beneficial in cases pf 
cough, asthma, Kushtha, parasites, catarrh, indigestion, 
aversion to food and Udavarta. 15. 

Second Anstha- Varti : —The inner pulp of 

the seeds of Madana fruits with Kutaja, Jimutaka, 
Ikshvdku (bitter gourd), Dhdmdrgava, Trivrit^ Trikatu^ 
mustard seed and rock-salt, should be pasted together 
with either the milky juice of Mahd-vriksha or with the 
urine of a cow ; and the paste should be made into 
thumb-shaped plugs (Varti). In a case of Anaha of the 
patient already suffering from Udara, the outer end of 
his rectum should be lubricated with oil and salt and 
one or two of the plugs should be inserted therein. The 
application of this Anaiha-varti should as well be 
applied in cases of Uddvarta, due to a suppression or 
retention of stool, urine, and Vata (flatus) and in 
cases of tympanites (Adhmdna) and distention of the 
abdomen (Andha). 16. 

Treatment of Plihodara :— In a case of 

Plihodara, * applications of Sneha (oil, etc.) and Sveda 

* Dropsical swelling of the abdomen owing to an enlargen^ent of the 
spleen^ 



Chap. XIV 3 CHIKITSA STHANAM. 399 

( fomentations ) should be made and the patient 
should be fed on boiled rice mixed with milk-curd. 
Then the vein (Sira) inside the elbow of his left hand, 
should be duly opened. The spleen should be rubbed 
with the hand for the proper out-flow of its deranged 
blood (for the relief of that enlarged organ). Then 
having properly cleansed his system, the physician 
should advise the patient to take the alkali of marine 
oyster-shells through the medium of milk. As an alter- 
nditive, Vava-ks/idra should be given to himwithSauvarc/i- 
ikd and Hingu, or with filtered alkali (made with the 
ashes) of Paldsa wood. As an alternative, the alkali 
of Pdrijdtaka, Ikshvdku and Apdmdrga^ mixed with oil, 
should be prescribed ; or the decoction of S'obhdnjana, 
mixed with Chitraka^Saindhava d^adPippali, or the alkali 
of Puti-karanja, filtered with Kdnjika and mixed with 
a copious quantity of Vid salt (black salt) and 
powdered Pippali should be administerd. 17. 

Shat-palaka Ghrita :— One pala weight of 

each of the following drugs, vizy Pippali^ Pippali-roots^ 
Chitraka, S'unthi, Yava-kshdra and Saindhava should 
be cooked with one Prastha measure of clarified butter 
and the same quantity of milk*. The medicated Ghrita 
thus prepared is called the Shat-palaka-Ghrita. It is high- 
ly efficacious in cases of an enlargement of the spleen, 
impaired digestion, Gulma, dropsy, Udavarta, swelling 
(Svayathu), jaundice, cough, asthma, catarrh, Urdhva- 
Vata and Vishama-Jvara. In cases of Udara attended 
with impaired digestion, the Hingva'di Churna should be 
prescribed. These measures should be as well employ- 
ed in a case of an enlargement of the liver (Yakrit), 
but the speciality is that the vein (inside the elbow) of 

* The practice, in this case, is to add twelve Seers (three prastha 
measures) of water to the Prastha measure of milk at the time of cooking. 



400 THE SUSHRUTA SAMHITA. [Chap. XIV. 

the right hand (instead of the left hand) should be opened 
in this case. i8. 

Metrical Text :— After slightly bending down 
the wrist (of the left hand), the vein in connection with 
the thumb of the left hand should be cauterized with 
a (burning) Sara for the purpose of giving relief in a 
case of enlarged spleen. 19. 

Treatment of Vaddha-gudodara, 

etc. : — In cases of the Vaddha-guda (Entertis) and 
the Parisraivi types of Udara, the patient should be 
first treated with emulsive measures and fomentations 
and then anointed with a sneha. Then an incision should 
be made on the left side of the abdomen below the um- 
bilicus and four fingers to the left of the line of hair which 
stretches downward from the navel. The intestine to the 
length of four fingers should be gently drawn out ; 
any stone, any dry hardened substance (Scybalum ?), 
or any hair found stiffing to the intestine should be 
carefully examined and removed. Then the intestine 
should be moistened with honey and clarified butter. 
It should then be gently replaced in its original 
position and the mouth of the incision in the abdomen 
should be sewn up. 20. 

Treatment of Parisrsivi-Udara :— In 

cases of the Parisrsivi type of Udara, the obstructing 
matter should be similarly removed (from the intestines), 
as in the preceding case, and the secreting intestine 
should be purified. The (two ends of the severed 
intestines should be firmly pressed and adhered toge- 
ther and large black ants should be applied to these 
spots to grip them fastly with their claws. Then the 
bodies of the ants having their heads firmly adhering to 
the spots, as directed, should be severed and the intes- 
tines should be gently reintroduced into their original 



Chap. XIV.) CHIKITSA STHANAM. 401 

position (with the severed heads of the ants adhering to 
the ends of the incision) and sutured up, as in the prece- 
ding case. A union or adhesion of the incidental 
wound should then be duly effected. The «=eam should 
now be plastered with black earth mixed with Yashti- 
madhu and duly bandaged. The surgeon should cause 
the patient to be removed to a chamber protected from 
the wind and give him the necessary instructions. The 
patient should be made to sit in a vessel full of oil or 
clarified butter and his diet should consist only of 
milk. 2r. 

Treatment of Udakodara :— A patient 

afflicted with Jalodara (ascites) should be first anointed 
with medicated oils, possessed of Vdyu-subduing virtues, 
and fomented with hot water. Then his friends and 
relatives should be asked to hold him firmly by his 
arm-pits, when the surgeon would make a puncture with 
a surgical instrument, known as the Vrihi-mukha, on 
the left side of the abdomen below the umbilicus, to the 
breadth of the thumb in depth and at a distance of 
four fingers to the left of the dividing line of hairs 
in the abdomen, Simultaneously with that, a metal 
tube or a bird's quill, open at both ends, should be 
introduced through the passage of the puncture to allow 
the morbific fluids (Doshodoka), accumulated in the 
abdomen, to ooze out. And then having removed the 
tube or the quill, the puncture should be lubricated with 
oil and Saindhava salt and bandaged in the manner 
described in connection with the bandaging of ulcers. 

The entire quantity of the morbific fluid should not 
be allowed to ooze out in a single day, inasmuch as 
thirst, fever, aching of the limbs, dysentery, dyspnoea 
and a burning of the feet (Pdda-djiha) might supervene in 
consequence, or as it might lead to a fresh accumulation 

51 



402 THE 5USHRUTA SAMHITA. |[Chap. XIV. 

of matter in the abdomen, in the event of the 
patient being of a weak constitution. Hence it should 
be gradually tapped at intervals of three, four, five, six, 
eight, ten, twelve, or of even sixteen days. After the 
complete outflow of the fluid, the abdomen should be 
firmly tied with a piece of flannel, silk-cloth or 
leather, inasmuch as this would prevent its flatulent 
distention. 

Diet;— For six months the patient should take 
his food only with milk or with the soup (Rasa) of 
Jdngala animals. 

The diet* for the next three months should consist of 
(meals taken with) milk diluted (and boiled) with an 
equal quantity of water or with the soup of flesh of 
animals of the Jdngala group seasoned with the juice 
of acid fruits. During the next three months it .should 
consist of light and wholesome meals. This rule 
observed for a year brings about a cure. 22. 

IVIemorable Verse :— Skilled physicians 

should prescribe boiled milk and the soup of the flesh 



* The use of water is forbidden during these nine months. 

During ihe first six months, drinking, washing, etc., should be done 
with milk or the soup of Jangala animals. After this period, the said 
purposes should be served with half.diluled milk or meat-soup seasoned 
with the juice of acid fruiis. Water may be used during the period of 
the next three months. —Dallana. 

Vagbhata following Charaka says: — 

The patient should live only on milk for six months. After this 
period, he should live on porridge (Peya) boiled with milk ; and for the 
next three months he shoull live on boiled S'y^ma-rice with milk, 
or with the soup of meat seasoned with the juice or acid fruits and mixed 
with clarified butter and a small quantity of salt. 

The water of tender and green cicoanuts is used in cases of Udara 
in place of pure drinking water with benefit. — Ed. 



Chap. XIV.] CHlkltSA STHANAM. 403 

of animals of the Jdngala group as food and drink 

in all cases of Udara and use these as Asthapana 
measures and as purgatives as well. 23. 



Thus ends the fourteenth Chapter in the Chikitsita Sth^nam of the 
Sus'rula Samhitd which deals with the treatment of Udara. 



CHAPTER XV. 

Now we shall discourse on the (surgical and medical) 
treatment of the cases of difficult malpresentation of the 
foetus and of difficult labour (Mudha-Garbha). i. 

The extraction of a foetus, acting (^in the womb) as 
an obstructing Salya (foreign matter lodged in the body), 
is the most difficult of all surgical operations, inasmuch 
as actual contact or actual manipulation is the only 
means accessible to a surgeon in the region of the pelvic 
cavity, the spleen, the liver, the intestines and the 
uterus. All surgical acts in respect of the foetus or the 
enceinte, such as lifting up, drawing down, changing of 
postures (version), excision, incision, the cutting of limbs 
and section, pressure, the straightening and the perforat- 
ing of the abdomen, could not be done otherwise than by 
actual contact of the hand, which may sometimes 
prove fatal to the foetus or to the enciente. Hence the 
king should be first informed (as success in these cases 
is often uncertain) and all acts should be performed 
with the greatest care and coolness. 

We have stated before that the foetus is generally 
presented in cases of difficult labour in eight different 
postures or forms. The obstruction of the child in the 
passage of parturition (Garbha-Sanga) may be effected 
in three different ways, owing to its head, shoulders or 
hips being presented in a wrong way and held fast in 
the passage. Every care should be taken and no pains 
spared to bring a child alive into the world, which is not 
already dead in the womb. The sacred verses (Mantras), 
possessing of the virtue of bringing out the foetus, should 
be recited in the hearing of the enciente in the case of a 



dhap. XV.] CHlklTSA STHANAM. 4O5 

failure in the first attempts at effecting parturition. 
The mantras are as follows. 2. 

Metrical Texts :— ''O thou beautiful damsel, 
may the divine ambrosia' and the Moon god with Chitra- 
bhdnu and the celestial horse Uchchaih-Sravas take 
their residence in thy room ; may this water-begotten 
nectar, help thee, O lady, in swiftly casting off thy womb. 
May the Sun, the Vdsavas and the Wind-god (Favana) 
in the company of the saline Ocean give thee peace. 
The incarcerated beasts have been freed from their 
fastenings and binding chords. The Sun god has freed 
his rays of light. Freed from all danger, come, O, 
come, O child, and rest in peace in these precincts," 3. 

Proper and useful medicinal remedies should also be 
employed for the delivery of the child. 

Postures of the Foetus:— In the case of the 

foetus being dead in the womb, the enciente should be 
made to lie on her back with her thighs flexed down 
and with a pillow of rags under her waist so as to keep 
it a little elevated. Then the physician should lubri- 
cate his (own) hand with a compound consisting of earth, 
clarified butter and (the compressed juice of) S'allaki^ 
Dhanvana and S'dhnali and inserting it into the passage 
of parturition (Yoni) should draw out the dead foetus 
(downward with the hand). 4. 

In the case of a leg-presentation (Sakthi), the foetus 
should be drawn downward by pulling its legs. In case 
where a single leg (Sakthi) is presented, the other leg of 
the foetus should be expanded and then it should be 
drawn downward. 

In the case of the presentation of the buttccks(Sphik). 
I breech presentation), the buttocks should be first pressed, 
and lifted up and then the foetus should be drawn 
downward by the legs. In the case of a longitudinal 



406 THE SUSHRUTA SAMHITA, [Chap. XV, 

presentation (the child coming stretched cross-wise) like 
a belt and arrested in the passage, its lower extremities 
should be pushed upward with the hand and the child 
should be drawn out with its upper part (viz., the head, 
etc.), thus pointed downward, and brought straight into 
the passage of parturition. In a case of the head being 
hung back a little on one side, the shoulder should be 
lifted up by pressing it (with the hand) after chafening 
it, so as to bring the head at the door of the passage 
and the child should be drawn straight downward. 
Similarly in the case of the presentation of the two 
arms, the shoulder should be lifted up by pressing it 
(with the hand) and, the head being brought back to 
the passage, the child should be drawn downward. 
The remaining two kinds of false presentation 'Mudha- 
garbha) previously described (in the eighth Chapter of 
the Niddna Sthana) should be considered as irreme- 
diable. The applications of instruments (Sastra) should 
be the last resort when such manipulatory measures 
would fail. 5. 

IVletrfCal Text : —But even in such irremediable 
(Asadhya) cases, surgical operations should not be made 
if the foetus could be detected alive in the womb, as 
such a course (as the cutting of the foetus, etc.) would 
fatally end both as regards the child and its mother. 6. 

Operations involving destruction of 
the Foetus— Craniotomy :- In cases where 

there would be any necessity of using an instrument for 
the purpose of delivery, the enciente should be en- 
couraged (with hopes of life) before making the surgical 
operation. The head or skull of the child in such 
cases should be severed with the knife known as the 
Mamlaldgra or the Anguli-^astra ; then having carefully 
takdrt out the particles of the skull-bone (Kap^la), 



Chap. XV.3 CHIKITSA STHANAM. 40/ 

the foetus should be drawn out by pulling it at its chest 
or at the shoulder with a Sanku (forceps). Where the 
head would not be punctured and smashed, the foetus 
should be drawn out by pulling it at the cheeks or the 
eye-sockets. The hands of the foetus should be severed 
from the body at the shoulders, when they (the shoulders) 
would be found to have been obstructed in the passage 
and then the foetus should be drawn out. The abdomen 
of a child, dead in the womb, should be pierced and the 
intestines drawn out, in event of the former being swollen 
into a flatulent (Vdta) distension like a leather bag vfor 
holding water), as such a procedure would remove the 
stiffness of its limbs, and then it should be drawn out. The 
bones of the thighs ( Jaghana-kapala) should be first cut 
out and removed, where the foetus would be found to have 
adhered fast to the passage with its thighs ijaghana). 7. 
lYIetrical Texts :— in short, that part of the 
body of the foetus should be severed and removed 
which (prevents its (foetus) withdrawal from the womb 
and the life of the mother should be saved at all 
hazards. The different types of false-presentations 
should be ascribed to the abnormal coursing of the 
deranged Vayu (in the uterus), and hence an intelligent 
physician should adopt, after careful considerations, 
proper remedies (for its pacification). An intelligent 
physician should not waste a single moment in drawing 
out the foetus, as soon as it would be found to be dead 
in the womb, since neglect in such cases leads to the 
instantaneous death of the mother, like an animal dying 
of suffocation. An erudite physician, well-versed in 
a'natomy, should use in such cases a MandaUgra instru- 
ment for the purpose of cutting out '.the foetus), since 
a sharpe-edged Vriddhi-patra may sometimes hurt the 
mother during the operation. 9-10. 



408 THE SUSHRUTA SAMHITA. [Chap. XV. 

A non-falling placenta (Aparai) should be extracted 
in the way indicated before or the enciente should be 
firmly pressed and the placenta extracted with the 
hand. Her body should be constantly shaken or 
her shoulders constantly rubbed at the time (of 
extracting the placenta') after lubricating the passsage 
of parturition with oil. i r . 

After- measures :— Thus having extracted 
the Salya (foetus^, the body of the mother should b^ 
washed with warm water and anointed with oil, etc. 
Oil should also be copiously applied to the passage of 
parturition * as it would soften the Yoni and alleviate 
the pain therein. After that, powdered Pippali, 
Pippali-roots^ S'unthi, Eld^ Hingii^ Bhdrgi, Dipyaka, 
Vachd, Ativishd, t<dsnd and Chavya should be given 
in a Sneha (clarified butter, etc.), for the (proper) 
discharge (2>., purification) of the Uoshas (lotia) and for 
the alleviation of the pain. A plaster, or a decoction, or 
a pulverised compound of the said drugs without the 
addition of any Sneha (clarified butter, etc.) may also be 
given to her. As an alternative, the physician should 
ask the parturient woman to take S' dka-hdixV^ Hingu, 
Ativishd, Pdthd, Katu-rohini and Tejovati prepared and 
administered in the preceding manner. Then for 
three, five or seven days, Sneha (clarified butter, etc.) 
should again be given ; or the patient should be asked 
to take well prepared Asavas and Arishtas at night time. 
A decoction of the bark of S'irisha and Kakubha 
should be used for washing (Achamanaf) purposes and 
the other supervening distresses {i.e.^ complications) 
should be remedied with proper medicines.. 12- A. 

* The oil should be introduced into the vaginal canal by means o. 
PicllUt i e.y cotton plugs soaked in oil, etc. 

t This decoction should be specially used for 1 washing the uterus 
(Yoni).— Ed. 



Chap. XV.] CHIKITSA STHANAM. .469 

Diet and regimen of conduct :— The 

mother should always be neat and clean and subjected 
to a course of a small quantity of wholesome and 
emollient diet and to daily anointments and foment- 
ations ; and she should be advised to renounce all anger. 
Milk cooked with the Viyu-subduing drugs should be 
used for the first ten days. Meat-soup should then be 
prescribed for another such period, after which a diet 
should be prescribed according to the patient's health 
and nature. This regimen should be observed for a 
period of four months, after which, the patient would 
be found to have regained her health, strength and 
glow of complexion, without any complications, when the 
medical treatment, etc , should be discontinued. 12-14. 

The following Vald-Taila should be used for apply- 
ing into the Yoni (Vagina, etc.), for anointing the body 
and for drinking and eating purposes (i.e., along with 
other food) as well as for Vasti-Karma, as the oil is 
highly efficacious in curbing the action of the deranged 
and aggravated bodily Va(yu. 15— A. 

The ValSL Taila : -* An adequate quantity of 
sesamum oil should be cooked with eight times as much 
of the decoction of each of the following ; viz., Vald 
roots, Dasa-mula and the three combined drugs of Yava^ 
Kola and Kulattha and with eight times as much of 
milk and (one-fourth as much of) a paste (Kalka) com- 
pound of the drugs included in the Madhura group as 
well as with Saindhava-sdXt, Aguru, Sarja-rasa, Sarala- 
Kdshtha^ Deva-ddru, Manjishthd, Chandana^ Kushthay 

* Four seers of sesamun oil, thirty-two seers of the decoction of the 
Vala-roots, thirty-two seers of the decoction of Das'a-mula, thirty-two 
seers of the decoction of the drugs Yava, Kola and Kulattha taken 
together, thirty-two seers of milk and one seer of the paste compound 
(Kalka) should be taken in the preparation of the oil. 

52 



410 THE SUSHRUTA SAMHITA. [Cihap. XV. 

Eld^ Kdldnusdrivd, Mdnsi, S' alley a, Teja-patra, T agar a, 
S'drivd^ Vachd^ S'atdvari, As'va-gandhd, S'dta-pushpd 
and Punarnavd. After the completion' of its cooking 
the oil should be kept carefully in a golden, silver, or 
earthen pitcher with its rnouth well-stoppered. This oil 
is known as the Valai-Taila and proves curative in all 
diseases due to the action of the deranged Vdyu. A 
newly delivered woman should use this oil in adequate 
doses, according to her physical condition. Women 
wishing to be mothers and men seeking the blessings 
of fatherhood should use this Taila, which proves 
equally beneficial in cases of an emaciation of the body 
due to the action of the deranged Vayu, weariness of 
the body through hard labour, and also in cases of hurt 
or injury to any vital and vulnerable part of the body 
(Marma), in cases of fractured bones, convulsions, Vata- 
Vyddhi, hiccough, cough, Adhimantha, Gulma and 
dyspnoea. A case of hernia would likewise yield to the 
continuous use of this oil for six months. The essential 
and vital principles (Dhatus) of the organism of a man 
are strengthened through its use and his youth will 
suffer no decay. It should be used alike by kings, king- 
like and wealthy persons, as well as by those of a 
delicate and ease-loving temperament. 15— B. 

The Vala-Kalpa :— Seeds of sesamum 
should be successively soaked a number of times in a 
■decoction of Vald roots* and then dried (in the manner 
of a Bhavana saturation). The oil pressed out of such 
sesamum should be successively cooked a hundred times 
with the decoction of Va/d-roots. This being done, the 
oil should bs poured into an earthen pitcher and the 

* Vala wouM be the Kalka in this oil, says Dallana. But he also says 
that some authorities hold that the Kalkas used in the Vala-Taila should 
be used as the Kalka in this oil as well. 



Chap. XV.] CHIKITSA STHANAM, 4II 

patient, while taking it in adequate doses, should live 
in a lonely chambsr protected from the wind. After its 
digestion, the patient should partake of milk and boiled 
Shashtika rice. A Drona measure of the oil, should in 
this way, be gradually taken and the regimen of diet 
(milk and Shashtika rice, etc.) should be observed for 
double that period. This oil is efficacious in improving 
one's strength and complexion and adds a century (of 
years) to the duration of one's life, and at the same time 
absolves him from all sins. It is said that the use of each 
succesive Drona measure of this oil adds a century to 
one's days on earth. 16. 

Oils may similarly be prepared with each of Ativishd^ 
Guduchi, Aditya-parni^ Saireyaka, Virataru, S'atdvari^ 
Tri-kantaka, Madhuka and Prasdrani, and may be 
prescribed by an experienced and erudite physician. 17. 

Nilotpala and S^atdvari should be cooked in milk. 
The milk thus prepared should be again cooked with 
sesamum oil successively a hundred times and a 
paste of all the drugs used as a paste in the Vala^ Taila 
should be added to it at the time of cooking. The 
therapeutic virtues of all these oils are the same as 
those of the Vald-Taila and the same regimen of diet 
and conduct should be observed in all such cases. 18. 

Thus ends the fifteenth Chapter of the Chikitsita Sthanam in the 
Sus'ruta Samhita which deals with the medical treatment of Mudha- 
garbha. 



CHAPTER XVI. 

Now we shall discourse on the medical treatment 
of Abscesses and Tumours (Vldradhl). i. 

Of the six types of Vidradhis, the one of the Sanni- 
pdtika type should be regarded as incurable In all 
other types curative measures* should be speedily 
resorted to in their unsuppurated stage, as in the treat- 
ment of a case of Sopha (inflammatory swelling or 
boil). 2. 

Treatment of Vataja-Vidradhi :— in 

a case of Vdtaja Vidradhi, a compact or thick plaster 
(Alepa) composed of pasted Murang'i-r oots,f mixed 
with clarified butter, oil and lard (Vasa), should be 
applied lukewarm. The flesh of the animals which 
frequent swamps and marshes as well as of aquatic ani- 
mals boiled with the drugs of the Kdkolyddi group, 
Kdnjika, salt, barley powder and Sneha (clarified 
butter, &c.), should be applied as a poultice (Upandha>, 
and the affected part should be constantly fomented 
with (warm) Ves'avdra, Kris'ara, milk and Payasa. 
Blood-letting should also be resorted to. 3. 

If, in spite of the use of the preceding remedies, 
'suppuration should begin to set in, suppurating measures 
should be resorted to and the abscess (finally) lanced 

* Commencing with Apatarpana up to purgative measures (Chikitsd, 
chapter.— I ). 

t Both Dallana and Chakrapani Datta read "Vataghna" in place of 
**Murangi" of the text. Dallana explains the term "Vataghna" as the 
•'Bhadra-darvadi group" and S'iva-dasa, the commentator of Chakrapani, 
explains it as the "Das'a-mula". Both of them, however, say that he 
different reading is "Surangi" meaning "S'obhdnjana." **Murangi" also 
means "S'obhdnjana."— Ep. 



Chap. XVI.] CHIKITSA STHANAM. 413 

With a knife. Cleansing measures should then be applied 
to the (incidental) ulcer. After incision, the ulcer 
should be washed with a decoction of the Pancha-mula ; 
and an oil cooked with the drugs of the Bhadra-ddrvddi 
group and Yashti-madhu, and, mixed with an abundant 
quantity of salt, should be used in filling (healing up) 
the cavity of the wound. The cleansing of the ulcer 
should be effected with the powdered Vairechanika 
(purgative) drugs mixed with Traivrita* and the 
healing should be effected with Traivrita cooked with 
the drugs of the Prithak-parnyddi group. 4-6. 

Treatment Of Pittaja Vidradhi:— In a 

case of Pittaja Vidradhi a plaster (Pradeha) composed 
of sugar, fried paddy, Yashti-Madhu and Sdrivd pasted 
with milk should be applied, As an alternative, a 
plaster composed of Payasyd, Us'ira and (red) sandal 
wood pasted with milk should be used. Cold infusions 
of Pdkya (Yava-kshdra), sugarcane-juice and milk, and 
jivaniya-Ghrita mixed with sugar should be used in 
affusing the abscess. The patient should be advised to 
lick a lambative composed of powdered Haritaki 
and Jrivrit saturated with honey ; and leeches should 
be applied (to an unsuppurated) abscess for letting out 
the blood. An intelligent surgeon should (lance a 
suppurated abscess and) wash the incidental ulcer with a 
decoction of Kshira-Vriksha or of aquatic bulbs. 
Poultices of sesamum and Yashti-Madhu mixed with 
honey and clarified butter should then be applied to 
it and bandaged with a piece of thin linen. Clarified 
butter cooked with Prapaundarika^ Mmtjishtha, 
Yashti-Madhu, Us'ira, Padmaka^ Haridrd and milk, 

* "Traivrita" is a technical term and means clarified butter mixed 
with the three other lardacious substances, viz., oil, lard and marrow. 
Vide Chikitsita Sthdnam. Chapter— V. 



414 THE SUSHRUTA SAMHITA. [Chap. XVI. 

should be used to heal up the cavity of a Pittaja 
ulcer, by (inducing granulation). As an alternative, 
clarified butter cooked with Kshira-S'ukld, Prithak- 
parni, Samangd, Rodhra^ Chandana and the tender 
leaves and bark of the drugs of the Nyagrodhddi group 
should be employed for the same end. 7-10. 

Karanjadya Ghrita :— A Karsha measure 

of each of the following drugs, viz., the tender leaves and 
fruits of thQ]Naktamdla, the leaves of the Sumana (Jdti 
flower), Patola and of Arishta, Haridrd, Daru-Haridrd, 
wax, Yashti-Madhu, Tikta-Rohini, Priyangu? Kus'a- 
roots, Nichula-hdiXk, Manjishthd^ sandal wood, Us'ira^ 
Utpala, Sdrivd and Trivrit should be cooked with a 
Prastha measure of clarified butter. This medicated 
Ghrita is called the Karanjaidya Ghrita, and it 
will cure malignant ulcers (Dushta-Vrana) and act as a 
purifier in sinus and recent ulcers, etc., burns and scalds, 
deep sores and even deep-seated sinuses. 1 1. 

Treatment Of Kaphaja Vidradhi :— In 

a case of Kaphaja Vidradhi, the seat of affection should 
be fomented with a heated brick, sand, iron, cow-dung, 
husks, ashes and cow's urine.f The Doshas involved 
in such a case should be curbed down by a constant 
use of medicinal decoctions, emetics, plasters (Alepa) 
and poultices (Upanaha). The vitiated blood of the 
locality should be cuffed out with an Aldvu-yantra 
(gourd). The abscess when suppurated should be (lanced 

* Chakrapani Datta in his compilation does not include Priyangu, 
Kus'a-roots add Nichula-bark in the list but he reads both the kinds of 
sariva, i. e., Anantamula and S'yamd-lata. 

t In Chakradatta, the reading is ' % (^ fq ^;" i.e., pasted in cow's urine» 
instead of ♦•^pg^i^;" I S'ivaddsa, the commentator, however, holds that 
this reading is not authoritative, though he says that some commentators 
have accepted it. 



I 



Chap. XVI.] CHIKITSA STHANAM. 41S 

and) washed with a decoction of hragvadha. The 
sore of such an ulcer should be filled up (healed) with a 
medicinal compound consisting of the paste of Haridrd 
Trivrit, S'aktu, sesamum and honey and bandaged in 
the manner described before. After that, a medicated 
oil properly cooked with a paste of Kulatthikd, Danii^ 
Irivrit: S'ydmd, Arka, Tilvaka, cow's urine and rock- 
salt should be applied in such a case. 12-13. 

Treatment of Agantuja and Raktaja 

Vidradhi :— In a case of abscess of traumatic 
(Agantuja) origin, or due to the vitiated condition of the 
blood (Raktaja), all the measures and remedies laid 
down in connection with those of the Pittaja type 
should be employed by a skilled surgeon. 14 

Treatment of internal Vidradhi :— A 

case of an unsuppurated internal abscess yields to the use 
of a potion consisting of a decoction of the drugs of 
the Varunddi group saturated with the powders (Kalka) 
of those of the Ushakddi group. Clarified butter 
cooked with the decoction of the drugs of the two 
preceding groups, as well as clarified butter cooked with 
purgative |drugs, taken every morning, will cure an 
internal abscess in a very short time. The decoctions 
of the above groups should be mixed with Sneha (oil or 
clarified butter) and speedily used as an Asthdpana as 
well as an Anuvasana measure. The hsirk o{ Mad/m-s'tgru 
mixed with the powders of the drugs antidotal to the 
Doshas involved in the case, being administered in food 
and drink and used as a plaster, proves curative in a 
case of an internal abscess in its unsuppurated stage. 
As an alternative, the said drug (i.e., Madhu-s'igru) should 
be taken with water, Dhdnydmla, cow's rine, or Surd 
(wine). Purified S'ildjatu, Guggulu^ S'unthi, or Deva- 
^«V«, dissolved in the decoction of the drugs antidotal to 



4l6 THE SUSHRUTA SAMHITA. [Chap. XVI. 

the aggravated Doshas involved in the case, should be 
administered. Applications of poultices, Sneha-Karma 
(emollient measures), as well as Anulomana (Vayu-sub- 
duing) measures should be frequently resorted to in 
such cases. 15-20. 

The veins (S'ira) should be opened in a case of the 
Kaphaja type of abscess as directed before ; while 
some authorities advise to open the veins at the arms in 
cases of Raktaja, Vataja and Pittaja types. 21. 

Treatment of Suppurated internal 

Vidradhi :— A suppurated internal Vidradhi having 
bulged up (above the surface of the body) should be 
opened with a knife and treated in the manner of an 
(incidental) ulcer. Whether the pus drains through the 
lower or the upper channel of the body (rectum or 
mouth) the patient should be made to take the drugs of 
the Varunddi group or Madhu-s'igru mixed with (a 
copious quantity of) Maireyay Sura, Asava, or Kanjika. 
The diet should consist of rice boiled and cooked with 
white mustard seed in the decoction of Madhu-s'igru 
and taken with the soup of barley, Kola and Kulalttha 
pulse. The Tilvaka Ghrita (Chikitsa Sthdna, ch. IV.), 
or clarified butter cooked with the decoction of the 
Trivritddi group, should be taken every morning in 
adequate doses for the purpose. Particular care should 
be taken by the phsyician to guard against the suppura- 
tion of an internal abscess, since suppuration in such 
cases leads but to a slender hope of success. 22-23. 

Treatment of IVIajja-Jata Vidradhi : 

— The medical treatment of a patient, afflicated with a 
Majja-jata abscess (abscess affecting the marrow), should 
be taken in hand without holding out any definite hope 
of recovery fas a proper course of treatment in such 
cases does not invariably prove successful). Sneha-karma 



Chap. XVI. J CHIKITSA STHANAM. 417 

(anointments, etc.) and fomentations should be first 
resorted to, after which blood-letting should be 
made ; and the remedial measures of the present 
chapter should be then employed. When it reaches the 
suppurating stage, the bone should be operated upon, 
and after the full elimination of the pus and the putrid 
matter from the incised ulcer, purifying remedies should 
be employed. The incidental ulcer should be washed 
with the decoction of the bitter drugs and the Tikta- 
Sarpis* should be ujed. An intelligent physician 
should apply the decoction of the drugs of the 
Samsodhaniya group, if the oozing out of the marrow 
is not arrested. A medicated oil cooked with Priyangu, 
Dhdtaki, Rodhra, Katphala, Nemi\ and Saindhava 
salt should be used in healing up an ulcer incidental 
to an opened up Vidradhi. 24-25. 

Thus ends the sixteenth Chapter of the Chikitsita Sthanam in the 
Sub'ruta Samhila which deals with the treatment of abscess. 



* This medicated Ghrita (Chikitsita Sthdnam, Ch. IX) may be used 
both internally and externally with good results. Ed. 

t Dallana reads "Tini" in place of "Nemi," both of which, however, 
mean "Tinib'a". Chakradatta does not include "Saindhava" in the list, but 
reads "Tinio'a-twacham" in place of "Nemi-Saindhavam". S'ivad^sa, 
however, adds another reading 'Tinis 'am Dhavam" on the authority of 
Chandrala. 



-0-: — 



53 



CHAPTEE XVII. 

Now we shall discourse on the medical treatment of 
erysipelas, etc., (Visarpa), sinus, etc., (Nadl- 
Vrana) and diseases of the mammary glands 

(Stana-roga). i. 

Of the types of erysipelas (Visarpa) the first three 
(viz., the Vdtaja, Pittaja and Kaphaja ones) are curable ; 
the two remaining types, viz., those caused by the con- 
certed action of the three Doshas (of the body) and 
those originating from wounds (Kshataja) should be 
considered as incurable. In cases of the curable types, 
medicated Ghritas, plasters (Upadehas) and affusions 
(Seka) prepared with the drugs (antidotal to the specific 
aggravated Dosha or Doshas (involved in the case) 
should be prescribed. 2. 

Treatment of Vataja Visarpa :~ln 

cases of the Vsitaja type of the disease, Mustd, S'atdhvd, 
Sura-ddru, Kushtha, Vdrdhi, Kustumhuru (Dhanyaka) 
Krishna-gandhd, and the drugs of a heat-making potency 
(Ushna-gana)* should be used in preparing the medicinal 
washings (Seka), plasters and Ghritas. The drugs res- 
pectively included within the groups of the Vrihat- 
Pancha-mula and the Svalpa-Pancha-mula, the Kantaka- 
Pancha-mula and the Valli-Pancha-mula should be 
(separately) used to prepare the medicinal plasters, 
affusions, medicated Ghritas and as well as the neces- 
sary oils. 3. 

* Chakradatta reads "Arka", Vams'a and Artagala instead of the 
drugs of a heat-making potency. Dallana explains the drugs of a 
heat-making potency to be the drugs of the Bhadra-darvadi and the 
Pippalyddi groups. 



Chap. XVII.] CHIKITSA STHANAM. 419- 

Treatment of Pittaja Visarpa :— In 

cases of Pittaja Visarpa^ a plaster consisting of 
Kaseruka, S'ringd-taka, Padma, Gundrd ^Guduchi), 
S'aivdla, Utpala diX\d clay pasted together and mixed, 
with clarified butter, should be wrapped* in a piece 
of linen, and applied cool to the affected part. A 
paste composed of Hrivera, Ldmajjaka (Us'ira-mula), 
Chandana^ Srotoja (Rasanjana\ Muktd, Mani and 
Gairika, pasted together with milk and mixed with 
clarified butter should be applied thin and cool to the 
affected part to alleviate the pain. Pittaja erysi- 
pelas readily yields to the application of a medicinal 
plaster composed of Prapaundarika, Yashti-niAdhu, 
Payasyd, f Manjishthd, Padmaka^ Chandana and 
Sugandhikd pasted together. Decoctions of the drugs of 
the Nyagrodhddi group should be used in washing (the 
affected part) ; or clarified butter should be cooked with 
the expressed juice of the above drugs and employed 
in the case. The part may be affused (Seka) with cold 
milk (or water), or with water mixed with honey or 
sugar, or with the expressed juice of the sugarcane. 4-5. 
Gauryadi Ghrita:— A Prastha measure of 
clarified butter should be cooked with the Kalka of 
Gauri, \ Yashti-madhu, Aravmda, Rodhra, Ambu, 
Rdjddanay Gairika, Rishahhaka^ Padmaka^ Sdrivdy 
KdkoH, Medd, Kumuda, Utpala, Chandana, Madhu- 
S'arkard, Drdkshd, Stkird, Prts'ni-parni, and S'atdhvd 
taken in equal parts (and weighing one seer § in all) 

* In order to facilitate its removal. 

t It means "Kshira-vid^ri". Jejjata explains it as "Arka-pushpi'*. 

X Some explain it as "Haridra", while others explain it as 
"Gorochand". 

§ Dallana, however, says that these drugs will weigh four Pains 
i. e., half a seer in all. 



'420 THE SUSHRUtA SAMHITA. [Chap. XVII. 

and with the decoctions, weighing four times that of the 
Ghrita, of the drugs of the Nyagrodhddi, Sthirddi (minor 
Pancha-mula) and Vilvddi (major Pancha-mula) 
groups together with the same weight (sixteen seers) of 
milk. The washing (of the affected part) with this me- 
dicated Ghrita proves curative in Pittaja erysipelas and 
sinus. Visphota (boils\ head diseases, malignant sores 
and inflammatory affections of the mouth, yield to 
the internal use of this Ghrita. It is called the 
Giuryyaidi Ghrita and is highly efficacious in 
the derangements to which children are liable, (com- 
monly) attributed to the malignant influences of evil 
stars, as well as in cases of emaciated ones. 6. 

Treatment of Kaphaja Visarpa :— 

Cases of the Kaphaja type of Visarpa readily yield to a 
proper application of a medicinal plaster (Pradeha) 
composed of Aja-gandkd, As'va-gandhd, Sarald^ 
Kdld, Ekaishikd^ and Aja-s'ringiX pasted with 
the urine of a cow. Drugs, such as Kdldnusdryd, Aguru^ 
Chocha (cardamom), Gunjd, Rdsnd, Vachd^ S'ita-s'iva, 
Indra-parni^ Pdlindi, Munjdta and Mahi-Kadamba 
^applied similarly) are also efficacious in the present 
type. Drugs of the Varunddi group may be used in any 
form (such as plasters, washes, etc*\ for erysipelas. 
Blood-letting (by means of leeches) and Samsodhana 
(purifying) measures are the principal remedies in all 
cases of this disease (Visarpa^. Suppurated erysipelas 
should be first purified and then treated with the reme- 
dies described in the treatment of Vrana (ulcer), 7-8. 

* «'SaraU" here means '«Trivrit''. Chakradatta reads *'^[TW" 
which also means *'Trivrii", 

t 'Ekaishika," according to Uallana, would mean S'atdvari but 
S'ivadasa explains it as Pdlha. 

X Gayadasa explains it as Karkata-S'ringi. 



Chap. XVit] CHIKITSA STHANAM. 42 1 

Treatment of Nadi-vrana :— A Case of 

Naidi-Vrana (sinus) due to the concerted action of the 
three Doshas (Sannipatajaj baffles all cure, while the 
four remaining types are amenable to careful medical 
treatment. Poultices (Upandhiy* should be applied at 
the outset in the Vaitaja Nadi-Vrana and then 
the course of the pus-channels should be (ascer- 
tained and) fully opened (with a knife) and bandaged 
with a paste of sesamum, Apd^ndr^-a-SQeds and 
Saindhava salt. A decoction of (the drugs of) the 
Vrihat-Pancha-mula group should be constantly 
used in washing the ulcer. Oil f duly cooked with 
the following drugs, viz , Hinisrd, Haridrdy Katuka^ 
Vald, Gojihvikd and Viha-roots should be used for the 
purification, filling up and healing of the sores of 
the sinus. 9-1 r. 

Treatment of Pittaja Nadi :— In a case 

of Pittaji sinus, an intelligent surgeon should 
employ a porridge (Utkarikaj mixed with milk and 
clarified butter as a poultice, Then having opened 
the sinus with a knife, a plaster composed of Tzla, 
Ndga-danti and Yashti-madhu should be applied to 
heal it. A decoction of Soma, Nimba and Haridrd 
should be used by a skillful surgeon in washing the 
ulcer daily. A medicated Ghrita cooked with S'ydmd^ 
Trivrit, Triphald, Haridrd^ Ddru-Haridrd^ Rodhra 
and Kiitaja and with milk should be used to lubricate 
(Tarpana) the sinus. This Ghrita will even heal a sinus 
affecting the Koshtha. 12-13. 

* Poulticing with the drugs which induce suppuration is not approv- 
ed of by Gayaddsa. 

t Four seers of oil, the (Kalka) drugs combindely weighing one 
seer and sixteen seers of water are to be taken in its preparation. — 
Dallana. 



422 tME ^USHRUTA SAMHITA. [Chap. XVIt 

Treatment of Kaphaja Nstdi:— in a case 

of the Kaphaja type of the Nadi, the sinus should be duly 
poulticed i^Upanaha) with Kulattha, white mustard seeds, 
S'aktu and Kinva. When softened by its application, 
the direction of the sinus (with the help of a director) 
should be first ascertained ; and an expert surgeon should 
then open it fully with a knife and plaster it with a com- 
pound composed of Nimba, sesamum, Saindhava salt and 
Saurdshtra-mrittikd. A decoction (Sva-rasa-lit.— express- 
ed juice") of the Karanja, Nimba, Jdti, Aksha and Pilu 
should be used in washing the incidental ulcer. Oil duly 
cooked with Suvarchikd, Saindhava, Chitraka, Nikum- 
bha^ Tdli^ Nala, Rupikd and Apdmdrg-a-scQds and with 
cow's urine should be used for healing purposes. 14. 

Treatment of ^alyaja Nadi :— in a case 

of Salyaja Ns^di (incidental to any foreign matter into 
the body), the Salya should be first extracted by an 
incision into the sinus. Then having fully cleansed the 
channel, the ulcer should be purified with a plaster of 
sesamum profusely saturated with honey and clarified 
butter. It should hz then healed up. Oil cooked with 
the decoction of the tender fruits of the Kumb/izka, 
K/iarj'ura, Kapitthay Vilva and the Vanaspatis (Vata, 
etc."*, and with the Kalkas of Mustd^ Sarald^ Priyangu. 
Sugandhikd, Mocharasa, f Ahi-pushpa (Ndgesvara), 
Rodhra and Dhdtaki flowers leads to a speedy healing 
up (granulation) of ulcers (Vrana) and traumatic 
sinuses. 15. 

* Dallana's reading evidently is "Tali-lala" and he explains it as 
the roots of "Bhumyamalaki". Chakradalta also prescribes this oil but he 
takes "Nilika" instead of "Tali". S'ivadasa, again, in his commentary 
quotes from Sus'rula but reads "Nili-Nala* in place of "Tala-Nala." 

t "Mocha-rasa" is explained by Dallana lo be "S'obhdnjana," but it 
generally means '*S'almaIi-veshta/'and S'ivadasa ejcplains it as such. — Ed. 



Chap. XVII.] CHIKITSA STHANAM. 423 

Treatment with Kshara-Sutra :— An 

erudite surgeon should open a sinus, occurring in any 
of the Marmas, or in a weak, timid, or emaciated person 
with an alkalined string (KshaVa-Sutra\ and not with a 
surgical knife. The course of the sinus should be first 
ascertained with a director ; and a needle, threaded with 
a string of alkalined thread should be passed from one 
end of the sinus and quickly drawn out through the other. 
Then the two ends of the thread should be firmly fasten- 
ed together. An intelligent surgeon should likewise pass 
another alkalined thread in the event of the alkali of the 
first thread being comparatively weak. This should 
be repeated till the sinus completely bursts out. 
The surgeon should know that the same procedure 
may be as well adopted in cases of fistula-in-ano. 
Similarly in cases of tumours (Arvuda), etc. they 
should be lifted up (with the hand) and tied round at 
their base with an alkalined thread, or it should be 
punctured around with a kind of needle with their mouth 
resembling a barley corn and then tied again at their 
base with an alkalined thread. After their bursting (and 
falling offj, they should be treated as common ulcers 
(Vrana\ 16. 

The different kinds of Plug-Stick (Varti) described 
in the Dvi-Vraniya Chapter (Chikitsita—chap.-i.) may 
be similarly used with advantage in all cases of sinus. 
The use of a plug made of the following drugs, viz., 
the bark and fruit of the Ghonta, (the five officinal kinds 
of) salt,* LdksM, Puga and the leaves of the Alavand \ 

* According to Chakradatta's reading and S'ivadas's commentary there- 
on, only the Saindhava (instead of the five officinal kinds of sail) should be 
taken. We, however, follow Dallana's inttrpretation with good results. -j^^. 

t *'Alavana" has been explained by Dallana as "Kaka-mardanika" 
and by S'ivadasa as "Jyotishmati". S'ivadasa is, however, followed in 
practice in this case, 



424 THE SUSHRUTA SAMHITA. CChap. XVII. 

pasted together with the milky juice of the Snuhi and 
Arka leads to the speedy healing up of a sinus. The 
powdered* stones of Vibhitaka^ mangoe fruits, Vata- 
sprouts, Harenu, S'amkhini-setd, V drdhi-kanda mixed 
with oil can also be used in a case of sinus. 17-19. 

The seeds of the Dhustura^ Madana and Kodrava, 
Kos'dtaki, S'uka-nasd, Mriga-bhojani and the seeds and 
flowers of the ^f//>^^/<3; should be pounded together and 
applied to a sinus (Nddi) after having washed it with a 
decoction of Ldkshd. Cases of sinus speedily yield 
to the curative efficacy of the application of these 
powders mixed with oil. The use of the oil cooked 
with cow's urine and with the preceding drugs (as 
Kalkas) brings about the healing up of a sinus in seven 
nights. 20-21. 

The application of the oil cooked with the roots of 
the Pinditaka treated with the expressed juice of the 
Vardha-kanda in the manner of a BhAvand saturation 
and with the bulbs of Suvahd brings about a speedy and 
effective remedy for a sinus. The same effect is pro- 
duced by an application of the oil cooked with the 
bulbs of the the Vajra-kanda. 22. 

Bhallatakadya Taila:— The use of the 

oil cooked with the paste (Kalka) of Bhalldtaka, 
Arka, Marichdi Saindhava salt, Vidanga, Haridrd, 
Ddru-Haridrd and Chitraka and with the expressed 
juice of the Bhringa-rdja readily cures cases of sinus, 
Apachi and ulcer due to Vdyu and Kapha. 23. 

Treatment of Stana-roga : - In cases of 

a derangement of the milk (of the breast) a draught of 
clarified butter should be quickly given to the Dhatri 

* According to some different reading "burnt ashes" (instead of pow- 
ders) of the drugs should be taken. In our humble opinion the reading in 
the text seems to be the correct one, 



Chap. XVIL] CHIKITSA STHANaM. 425 

(mother ov wet-nurse) by the physician ; and in the 
evening a draught composed of the decoction of Nimba, 
mixed with honey and Mdgadhikd, should be given 
to her for emetic purposes. Next day she should 
take a meal (of boiled rice) with the soup (Yusha) 
of Mudga pulse. The use of emetics should be 
continued for three, four, or six days ; or she 
should be made to drink a potion of clarified butter 
(cooked) with Triphald, A decoction of Bhdrgi, 
Ativishd, Vachd, Sura-ddru, Pdthd, the drugs of the 
Mustddi Gana, Murvd and Katu-rohini, or that of the 
drugs of the Ai^agvadhddi group mixed with honey, 
should be given to the Dhdtri ^wet-nurse) for the purifi- 
cation of her breast-milk. 26. 

The above are the general remedial measures which 
are to be adopted in the affections of breast-milk. Any 
other defect in the breast-milk should be corrected 
specially with an eye to the nature of the Dosha 
involved in the case. In cases of inflammatory 
swellings of the breasts, the physician should remedy 
them by means of any one of the various measures laid 
down under the head of Vidradhi with a due considera- 
tion to the requirements of each particular case. Medici- 
nal remedies should only be internally employed and no 
poultices should be applied for the speedy suppuration 
of the swelling of the breast, even if found to have al- 
ready commenced to suppurate ; since the breasts are of 
an extremely soft and fleshy growth, any tight banda- 
ging about those parts may be followed by local slough- 
ing or even bursting. In a case where suppuration had 
already taken place, an operation should be made 
in the affected part, avoiding the milk-carrying veins 
as well as the nipple with its black surroundings. 
In all the cases of Stana-V id rad hi— whether 

54 



426 THE SUSHRUTA SAMHITA. [Chap. XVlt. 

non-suppurated, suppurating^, or suppurated— the 

milk should be pressed out from the breast of the 
Dhatri* 27-29. 

Thus ends the Seventeenth Chapter of the Chikitsita Sthanam in the 
Sus'ruta Samhita which deals with the treatment of erysipelas, sinus 
and the diseases of the mammary glands. 



* The milk should be pressed out of the Dhatri's breasts in the 
non-suppurated stage, to alleviate the burning sensation therein, in the 
suppurating stage for the avoidance of further suppuration, and in the 
suppurated stage for the prevention of sores, sinus, etc. 



CHAPTER XVIII. 

Now we shall discourse on the medical treatment 
of Glandular Swellings, etc. (Gratlthl), Scurvy 
(Apachi), Tumour, etc. (Arvuda) and Goitre 

(Gala-g^anda). i 

General treatment of Granthi :— In 

the non-suppurated or acute (inflammatory) stage of 
Granthi, an experienced physician should prescribe 
the measures # laid down in connection with (in- 
flammatory) swellings (Sopha) in general. As bodily 
strength arrests the progress of the disease, the 
strength of the patient should hence be always carefully 
guarded against suffering any diminution in that respect. 
The patient should be made to drink oil, or clarified 
butter, or both ; or he should be made to drink lard, 
oil and clarified butter, mixed together.f Apehivdtd 
(Prasarani) and Das'a-mula cooked with the four kinds 
of lardacious or emollient substances (oil, clarified 

* Beginning with Apatarpana up to the purgative measures. 

t Oil, clarified butter and lard mixed together is technically called 
the "Trivrita."— Dallana. 

In the case of a Vataja Granthi, a potion of oil cooked with the 
decoction and paste (Kalka) of the Vayu-subduing drugs should be 
prescribed for the patient ; in the case of a Pittaja Granthi, clarified 
butter cooked with the decoction and Kalka of the Pitta-subduing drugs 
should be administered in the same manner ; while in the case of a Kaphaja 
Granthi, oil cooked with the decoction and Kalki of the Kapha-subduing 
drugs should be taken by the patient. But in a case of Granthi due to 
the concerted action of the two, or three of the Doshas, any compound 
medicated oil, prepared by cooking any two, three, or four of the oily 
substances, viz.^ oil, clarified butter, lard and marrow, with the 
decoction and Kalka of those drugs which are antidotes to the said 
Doshas, should be prescribed for the patient as drinks, 



428 THE SUSHRUTA SAMHITA. [Chap. XVIII. 

butter, lard and marrow), or with any two of them 
should be prescribed. 2-3. 

Treatment of Vsitaja Cranthi :~A 

medicinal plaster composed of Himsrd, Rohiniy Amritd, 
Bhdrgi^ S'yondka, Viha, Aguru, Krishna-gandhd, Goji 
and Tdla-patri (Tdla-parni — D. R ) pasted together, 
should be applied ito the inflamed gland) in the 
Vaitaja type of Granthi. Different kinds of fomen- 
tation (Sveda), poulticing (Upanahaj and medicinal 
plasters (Lepa), possessed of the efficacy of subdu- 
ing the deranged Vdyu, should be likewise resorted to. A 
suppurated swelling should be opened and the pus drained. 
Then the incised wound should be washed with a 
decoction of Vilva^ Arka and Narendra (Aragvadha) 
and purified (disinfected) with a plaster consisting of 
sesamum and the leaves of the Panchndgula (castor oil 
plants), together with Saindhava salt. After the 
purification, it should be healed up by applying a 
medicated oil, mixed with the powders of Rdsnd and 
Sarald ; or by a medicated oil prepared by cooking it 
with Vidanga, Yashti-madhu and Amritd and cow's 
milk. 4. 

Treatment of Pittaja Granthi:— In a 

case of the Pittaja type of the disease, leeches should 
be applied to the affected part, which should be further 
affused with milk and water. The patient should be 
niade to drink a cold decoction of the drugs of the 
Kdkolyddi group with the addition of sugar ; or he 
should take the powders of Haritaki through the 
medium of grape-juice, or of the expressed juice of sugar- 
cane. Hot plasters, prepared by pasting together the 
bark of the Madhuka (flower) tree, and of the Jambu 

* Some read *'1%'^T^^^Tl%^ia:" and explain that the\decocUons of 
the Vilvadi and the Arkadi groups are to be taken for the purpose. 



Chap. XVIII. ] CHIKITSA STHANAM. 429 

tree, Arjuna tree, and Vetasa creeper. As an alter- 
native, hot plasters compounded of the roots of the 
Trina-s'unya (Ketaki), or Muchukunda mixed with 
sugar, should be constantly applied to the affected part. 
The Granthi should be opened when fully suppurated, 
and the pus let out ; after which it should be washed 
with a decoction of the bark of the Vanaspati^ The 
incidental ulcer should then be purified with a plaster 
composed of sesamum and Yashtimadhu ; and lastly it 
should be healed up with clarified butter cooked with 
the drugs of the Madhii7'a (Kdkolyadi group. 5-6. 

Treatment of Kaphaja Granthi :— In a 

case of the Khaphaja type of the disease, the Doshas 
should be first eliminated from the system with the 
regular and successive measures. f The affected part 
(Granthi) should then be fomented and firmly pressed 
(Vimlapana) and rubbed with either the thumb, or a 
piece of iron rod, or stone, or with a bamboo rod in order 
to bring about its resolution. A plaster composed of the 
roots of the Vikamkata, J Aragvadha, Kdkananti (Gunja), 
Kdkddani (Vayasa-tinduka), and Tdpasa-Vriksha 
(Ingudi) and with Pinda-phala (Tiktdldvu), Arka, § 
Bhdrgi, Karanja, Kdld and Madana^ pasted together, 
should be applied to it by an erudite physician. A 
glandular swelling v Kaphaja Granthi) on any part of the 
body other than a vital and vulnerable one (Marma) and 

* The Vanaspati class consists of Vata, Plaksha, As'vatlha and 
Udumbara frees. 

t These are ihe applications of Sn^ha, fomentation, emetics, pur- 
gatives, Asihapana, S'iro-virechana and blood- letting. 

X Dallana explains "Vikamkata" as "Kanta-karika," but it means 
Sruva (called Vainch in Bengal) and S'ivadasa also explains it as 
such,— i^r/. 

^ Chakradatia does not read "Arka" in the list. 



430 THE SUSHRUTA SAMHITA. [Chap. XVIII. 

not (otherwise) resolved and absorbed should be cut open 
even in its non-suppurated stage and the glands 
removed. The expert surgeon should then cauterize the 
incidental wound after the cessation of the bleeding and 
treat it in the manner * of the Sadyo-Vrana treatment. 
These remedies should be employed by the experienced 
physician, where the swelling would be found to have 
assumed a large, stiff, elevated and fleshy aspect 
(bulging from the deeper tissues of the flesh). A 
Kaphaja Granthi should be opened with an incision as 
soon as it becomes fully suppurated and should then be 
washed with a decoction of appropriate medicinal 
drugs. The incidental ulcer should be purified (disin- 
fected) with a purifying remedy prepared with a 
profuse quantity of Yava-kskara, honey and clarified 
butter ; and finally it should be healed up by the 
application of an oil, cooked with Vidanga, Pdthd and 
RoJiini. 7-9. 

Treatment Of Medoja Granthi : -In a 

case of Medoja Granthi (originated from the vitiated 
condition of the bodily fat) a plaster of pasted sesamum, 
placed inside the folds of a piece of linen, should 
be applied to the seat of the affected part and fomen- 
tations with hot iron- rods should be frequently applied, 
inasmuch as application of heat (lit. — fire) is efficacious 
in such cases. As an alternative, the affected part 
should be fomented with a ladle, pasted with heated 
shellac (Ldksha). The Granthi (in its non-suppurated 
stage) should be opened by an incision and the 
fat removed ; the incidental ulcer should then be 
(actually) cauterized. On the other hand, the Granthi, 
when fully suppurated, should be incised and washed 
with the urine (of a cow). Then a paste, composed of 
* Applications of honey, clarified butter, etc. 



Chap. XVIlI.] CHIKITSA STHANAM. 431 

sesamum, Suvarchikd, Haritdla and rock-salt, pounded 
together and mixed with honey, clarified butter and an 
abundant quantity of Yava-kshara, should be applied 
to the incidental wound for purifying purposes. Oil, 
cooked with the two kinds of Karanja, Gunjd^ the 
green scrapings of bamboo, Ingudi and the urine * of a 
cow, should be used to heal the ulcer. lo-ii. 

Treatment of Apachi :— Clarified butter 
cooked with the fruit of Jimictaka and Kosha-vati, 
and with (the roots of) Danii, Dravanti and Trivrit^ 
is a very powerful and efficacious remedy.-|* Adminis- 
tered internally as well as externally, it leads to the 
cure of the advanced cases of Apachi. 12. 

A strong emetic composed of Nirgundi, Jdti (flower) 
.and Varihistha (Vala) together "^ith. Jitmitaka, profusely 
mixed with honey and Saindhava, should be given 
warm to the patient. It is a very powerful emetic, 
and leads to the recovery of even a malignant form 
of Apachi. An oil, cooked with the pastes (Kalka) of 
Kaitaryya,\ Vimdiand Karavira^ may be profitably used 
as an errhine (Siro-virechana). Oil cooked with the 
expressed juice of S'akhotaka may also be used profit- 
ably as an errhine. § Avapida errhines (used in drops 

* Cow's urine measuring four times the oil should be taken in 
the preparation of this medicated oil. 

t In preparing this medicated Ghrita, the quantity of clarified 
butter should be taken four times as much as the combined weight of 
the Kalka (paste). These should be boiled with water, taken four times 
as much as the quantity of clarified butter. Some authorities, however, 
are of opinion that both the paste (Kalka) and the decoction of the drugs 
are to be taken in its preparation, 

X Some read *Nirgundi' after it. 

§ This medicated oil should be cooked without any Kalka. But some 
are of opinion that both the decoction and the Kalka of S'akhotaka should 
be used. 



43^ THE SUSHRUTA SAMHITA. [Chap. X III. 

into the nostrils) should be applied with Madkuka-sdra, 
S'ig'ru-sQeds and Apdmdr^a-seedsJ^ 13-15. 

A glandular swelling (Granthi), occurring in any 
part of the body other than a Marma, should be opened 
in its non-suppurated stage and cauterized with 
fire ; f or it should be rubbed with an alkali I after 
scarificaticn as already advised. 16. 

A length of twelve fingers should be measured 
(Mitvd) from and above the Parshni, i.e., the posterior 
side of the ankle (and the space of Indra-vasti above 
this part should be ascertained). The Indra-vasti 
(occupying a space of half a finger, or, according to 
others, two fingers) having been carefully avoided, an 
excision (on the opposite side of the affection) should 
be made and the spawn-like glands having been 
removed (therefrom), the excisioned part should be 
cauterised with fire. 

Others say that the excision should be made straight 
above the ankle (Ghona) after carefully avoiding the 
space of Indra-vasti, measuring two fingers (and to 
make sure an additional space of half a finger should 
be left out), which would be found out by taking one- 
eighth part (of the Jangha, 2>,, the leg— excluding the 
, foot and measuring twenty fingers) from the Khulaka 
(ankle-joint) of which the (two) Gulphas (ankles) look 
like the (two) ears. § 17-18. 

* Madhuka-sara mixed wiih tepid water and the expressed juice 
of S'igru-seeds and of Apamarga-seeds should be used. 

t In cases of the preponderance of Vayu and of Kapha. 

X In cases of the preponderance of Pitta. 

§ There is a good deal of difference as to the reading and explanation 
of this passage amongst the different commentators. The different explana- 
tions arise from the different interpretations put upon the word *'j}t%" 
in the Text, "qif^' 5if?T %K^ '^Tl^^TfT, etc." The words ''^]H 5rf?T" 



Chap. XVIII.] CHIKITSA STHANAM. 433 

As an alternative, the region of the wrist (Mani- 
bandha) should be branded by a physician with three 
mark lines, one finger apart, for a radical cure of 
Apachi. 19. 

may mean either of the following, (i) On the opposite side of the Parshni, 
Vagbhata subscribes to this view. (2) On the opposite {i.e.y the other) 
Parshni, that is to say, if the affection be on the right side of the body 
the operation should be made on the Parshni of the left leg and so on. 
Vriddha Vagbhata subscribes to this interpretation in the clearest 
language. (3) In the region of the Parshni, «.e,, on the dorsal side of 
the leg. 

The different commentators, again, do not agree as to the seat and 
extent of the excision. Some say that the operation should be made 
above the Indra-vasti and the extent should be two fingers in length. 
Vagbhata seems to subscribe to this view. Others hold that the operation 
should be made below the Indra-vasti and the extent should be two 
fingers' length : Dallana is of this opinion. A third class of commentators 
assert that the whole extent of the length from above the Parshni up to 
the Indra vasli should be opened. 

As to the extent of the Indra-vasti, again, there is a difference. 
According to Dallana it occupies a space of two fingers. But Jejjata 
holds that it occupies a space of half a finger only. The Indra-vasti 
(Marma) is situated twelve fingers above [i.e., in the thirteenth finger of) 
the Parshni. The reading in the printed editions of the text is "fifc^T", 
whereas Vrinda and Chakradatta read *'t%c^". Dallana's reading also 
evidently is "1%^". "fvTc^" would be quite redundant and as "f»f^" 
gives a better meaning, we accept this reading. 

Now we come to the second stanza. Commentators differ more in the 
exposition of this stanza than of the former. By the expression ''^rnr^^- 
^WR[ is meant by some commentators "from the Gulpha to the Kama." 
Others, however, mean to take it as an adjective to *'?I^rWTf^" and explain 
it as meaning "from above the Khulaka whereof the Gulphas look like 
the Karnas." As regards the expression "^fm^"^t^'/', some are inclined 
to think that the excision should be made straight above the Ghona 
(i.e., the posterior part and especially the big vein there which looks like 
the nose (Ghond) of the ankle-joint). 

Others, however, read it as "^t'HT^S^:" and explain it (^tWM^ + 
^p^) as meaning "in a straight line with the Ghon^ (which may mean 

55 



434 THE SUSHRUTA SAMHITA. [Chap. XVIII. 

The ashes (Masi) of the skins of a peacock, cow, 
h'zard (Godhd) and snake and of tortoise shells 
should be dusted (over an Apachi after lubricating it) 
with the (expressed) oil of the Ingudi. Medicated oils to 
be described under the treatment of Slipada (elephan- 
tiasis) and Vairechanika fumes should also be applied in 
a case of Apachi and the diet should consist of cooked 
barley and Mudga pulse. 20-21. 

Treatment of Vataja Arvuda :~ln a 

case of Vsitaja Arvuda, a poultice composed of 
Karkdruka, Ervdruka, cocoanut, Piydla and castor 
seeds, boiled with milk, water and clarified butter, 
and mixed with oil, should be applied lukewarm 
(to the tumour). As an alternative, a poultice 
made up of boiled meat or of Ves'a-vdra, should be 
applied to it. Fomentation of the part in the manner 
of aNaidi-sveda (application of medicated fumes through 
a pipe; should be applied by an experienced physician 
and the (vitiated) blood (of the locality) should be 
repeatedly cuffed off with a horn. S'atdhvd or Trivrit *, 
boiled with the decoction of the Vdyu-subduing 
drugs and with milk and Kanjika, should be given to 
the patient. 22-23. 

Treatment of Pittaja Arvuda : — 

Applications of mild fomentations and poultices (to the 

either the nose or the big vein (Kandara) at the heel looking like the 
nose (Ghona) of the ankle-joint and below the Indra-vasti". 

Dallana says that the part to be excisioned, according to the first 
stanza, is bBlow the Indra-vasti and that, according to the second, is 
above theflndra-vasti. We also think that the seat of the Indra-vasti 
should be carefully avoided and an excision should be made both above 
and below the Indra-vasti, according to the requirements in each case. 

* There is a different reading "^cTT^ 1%§fi" '" place of "gjcTfJ^J 
f(j(§ c['". In that case, roots of whitfe Trivrit should be boiled with the 
d^pocilon, etc" ■ ' 



Chap. XVIIL] CHIKITSA STHANAM. 435 

affected part) and of purgatives are efficacious in 
Pittaja Arvuda. The tumour should be well rubbed 
with (the rough surface of) the leaves of the Udumbara, 
S'dka^ or of the Goji and it should be plastered over 
with the fine powders of Sarja-rasa, Priyangu, Pattanga 
(red sandal wood), Rodhra, Anjana * and Yashti- 
madhuy mixed with honey. As an alternative, a plaster 
composed of Aragvadha, Goji, Soma and S'ydntd, 
pasted together should be applied to it after the 
secretion Visrdva. Clarified butter, cooked with 
Klitaka (as a Kalka) and with the decoction of S'ydmd, 
Girihvd, Anjanaki, Drdkshd and Saptalikd should be 
prescribed for internal application in a case of Pittaja 
Arvuda and of abdominal dropsy (Jathara) of the 
Pittaja type. 24-26. 

Treatment of Kaphaja Arvuda : — In 

cases of the Kaphaja type of Arvuda blood should be 
let out from the affected part after the system of the 
patient has been cleansed (by emetics and purgatives). 
Then a medicinal plaster composed of the drugs,-|* which 
are efficacious in correcting the Doshas, confined to the 
upper and lower parts of the organism, should be 
applied hot to the tumour. Or a plaster composed of 
Kdnsya-nila, S'uka^ Ldngaldkhya and Kdkddani roots, 
and the dung of a Kapota and of Pdrdvata pasted 
together with urine, or with alkaline water should be 
applied to it. The Kalkas (pastes) of Nishpdva{^'\m\A)^ 
Pinydka (oil-cakes of sesamum) and Kulattha pulse, 
pasted with curd-cream and an abundunt quantity of 
flesh, should be used in plastering the affected part so 
that worms and parasites may be produced in the ulcer 

* Chakradatta reads **Arjuna" in place of "Anjana". 
t These are the drugs included in the emetic and purgative groups 
(see chap. XXXIX. Sutra Sthanam). 



436 THE SUaHRUTA SAMHITA. [Chap. XVIIL 

and flies attracted to it (and so consume the ulcer). A 
small portion of the ulcer, left unconsumed (un-eaten) 
by worms and parasites, etc., should be scarified and 
the ulcer should then be cauterised with fire. 27-28. 

A comparatively superficial tumour (Arvuda; should 
be covered with thin leaves of zinc, copper, lead, 
or of iron, and cauterization with fire or with an 
alkali as well as surgical operations should be carefully 
and repeatedly resorted to, so as not to hurt, nor in any 
way injure the body. The incidental ulcer should be 
washed with the decoction of the leaves of the Asphota, 
fdti, and Karavira for the purpose of purification. A 
medicated oil, cooked with Bhdrgi, Vidanga, Pdthd,^,x\d 
Triphald should then be used as a healing remedy. An 
experienced physician should treat a tumour, sponta- 
neously suppurating, in the manner of a suppurated 
ulcer. 29-31. 

Treatment of Medoja Arvuda :— A 

Medoja Arvuda (fat origined tumour) should be first 
fomented and then incised. The blood in its inside 
having been cleansed it should be quickly sutured and 
then plastered over with a compound composed of 
Haridrd, Griha-dhuma (soot of a room), Rodhra, 
Pattanga, Manahs'Ud and Haritdla pounded together 
and mixed with a proper quantity of honey After its 
purification, thus produced, it should be treated with 
the application of Karanja-Taila (prescribed before in 
•cases of Vidradhi). Even the least particle of Doshas 
(pus, etc.) in a tumour, left unremoved, would lead 
to a fresh growth of the excrescence and bring on death 
just like the least particle of an unextinguished fire. 
Hence it should be destroyed in its entirety. 32-33. 

Treatment of Vataja Gala-ganda : — 

A case of the Vaitaja type of Gala-ganda (goitre) should 



Chap, XVIIL] CHIKITSA STHANAM. 437 

be treated with fomentations of the vapours of the 
decoctions of tender leaves of the Vayu-subduing drugs 
prepared by boiling them with Kanjika, various kinds 
of urine and milk as well as with minced meat and oil, 
and should be applied in the manner of a Nadisveda. 
After this fomentation, the contents should be carefully 
drained ^from inside the goitre). Then after having duly 
purified (the incidental ulcer), it should be plastered with 
a medicinal compound composed of (the seeds ofj the 
S'ana^ Atasi, Mulaka, S'igru and sesamum and Kmva 
and the piths of the Piydla^ or with that composed of 
Kdld, Amritd, S'igru, Pufzamavd, Arka, Gaja-pippali, 
Kara/idta {Ma.da.na.) a.nd Kus/it/ia, or with that com- 
posed of Ekazs/nkd, Vrikshaka and Tilvaka. All of 
them should be pasted with Sura and Kanjika and ap- 
plied hot to the affected part. The internal u^e of a 
medicated oil, cooked* with Ainritd, Nimba, Hamsdhvd, 
Vrikshaka, Pippali, Vald, Ati-vald, and Deva-ddru, 
always proves efficacious in a case of goitre. 34-36. 

Treatment of Kaphaja Cala-ganda : 

— A case of the Kaphaja type of goitre should be treated 
with applications of fomentation and poultice and 
should be duly drained (Visrava). Then a medicinal 
plaster composed of Aja-gandhd, Ati-vishd, Vis'afyd, 
Vishdnikd, Kushtha, S'ukdhvayd, Gunjd (taken in 
equal parts) and pasted with the alkaline water 
prepared from the ashes of the Palds'a wood should 
be applied hot to the affected part. A medicated oil 
cooked with the drugs of the Pippalyddi group and 
mixed with the five officinal kinds of salt should 

* Some say that the oil should be prepared with the decoction as 
well as with Kalka of the said drugs. Others, however, hold that water 
should be used in the preparation of the oil and the said drugs should be 
used only as a Kalka. 



438 THE SUSHRUtA SAMHiTA. CChap. XVIII. 

be taken by the patient. Emetics, errhines and 
inhalations of Vairechanika-dhuma are beneficial in such 
cases. In the Va'taja and the Kaphaja types of goitre 
(Gala-ganda), the skilful physician should employ 
suppurating measures in partially suppurated cases. 
The patient*s diet should consist of rice, barley and 
Mudga soup and should be taken with honey, Trikatu, 
cow's urine, fresh ginger, Patola and Nimba. 37-39. 

Treatment of Medoja Gala-ganda :— 

In a case of a Medoja goitre (due to the deranged fat\ the 
patient should be first made to use oleaginous substances 
(internally and externally) and venesection should then 
be resorted to, as advised before (Sarira-Sthdna. Ch VIII). 
A hot plaster composed of S'ydmd (Trivrit), Sudhd, 
Manduray Danti and Rasdnjana pasted together should 
be applied to the seat of the disease. Powders of the 
essential parts (Sara) of a S'dla tree mixed with cow's 
urine may be given every morning with advantage. 

As an alternative, the Goitre (Gala ganda) should 
be opened, its fatty contents fully removed and the 
wound then sutured. Or it should be cauterised with 
the application of heated animal marrow, clarified 
butter, lard, or honey ; after which it should be lubri- 
cated with clarified butter and honey (mixed together), 
and a pulverised compound of Kdsisa, Tuttha, and 
Gorochandy should be applied to it ; or after lubricating 
it with oil, it should be dusted with the ashes of cow- 
dung and of S'dla-sdra. Daily washings with the decoc- 
tion of Triphald, hard bandaging and a diet of barley, 
prove efficacious (in cases of goitre). 40. 

Thus ends the Eighteenth Chapter of the Chikitsita Sthdnam in the 
Sus'ruta Samhitd, which deals with the medical treatment of Glands, 
Scrofula, Tumour and Goitre. 



CHAPTER XIX. 

Now we shall discourse on the medical treatment of 
hernia, hydrocele, scrotal tumour, etc. (Vriddhi), 
diseases of the genital organ (UpadamS'a) and 
elephantiasis (Slipada). i. 

In the six types of Vriddhi other than the one 
known as the Antra- Vriddhi (Hernia), riding on horse 
back, etc., excessive physical labour, fastings, sitting in an 
unnatural position, constant walking, voluntary restraint 
of any natural urging (for stool and urine, etc.), sexual 
intercourse and eating of food difficult of digestion 
should be avoided. 2. 

Treatment of Vataja Vriddhi :— In 

the VaLtaja type of Vriddhi, the patient should be first 
soothed (Snigdha) with the application of Traivrita 
Ghrita (vide, Chap. V. Chikitsita Sthana). He should then 
be duly fomented and subjected to a proper course of 
purgatives. As an alternative, he should be made to 
drink the expressed oil of the Kos'dmra^ Tilvaka, or 
Eranda {cdiStor) oil (as a purgative) with milk for a month. 
A decoction of the Vayu subduing drugs mixed with 
the powders of the same drugs should then be employed 
by an experienced physician at a proper time * in 
the manner of a Niruha Vasti. The patient should 
then be made to take a meal (of boiled rice'; along with 
meat soup ; and oil cooked with Yashti 7nadhti should be 
applied (in the manner of an Anuvasana measure). 

* After a period of one week from the time of the application of 
purgatives and in case the patient is strong enough to undergo the 
Niruha. Vast! measure, 



440 THE SUSHRUTA SAMHITA. [Chap. XIX. 

Applications of Sneha (oil, etc.), poultices (Upandha), 
and plasters (Pradeha) of the Vdyu-subduing drugs should 
be applied to the affected part. If the tumour (Vriddhi) 
begins to suppurate, it should be made to do so 
fully. It should be then opened with an incision 
avoiding the median line (Sevani) of the perineum 
and the proper purifying (i.e., antiseptic and healing) 
measures should be resorted to in the usual way 
laid down (in the treatment of Dvi-vrana*). 3. 

Treatment of Pittaja Vriddhi :-^A 

case of the non-suppurated stage of Pittaja Vriddhi 
may be beneficially treated with the remedies laid 
down in connection with a case of the same type of 
glandular swelling (Pittaja Granthi). In the case of 
it being suppurated, the surgeon should open it with 
a knife and purify it with the application of honey 
and clarified butter. The incidental ulcer should then be 
healed up with oils and pastes of healing virtues. 4. 

Treatment Of Raktaja Vriddhi :-ln a 

case of Raktaja Vriddhi (originated through the vitia- 
ted condition of the blood), the (vitiated) blood should 
be drawn out by the application of leeches. As an 
alternative, purgatives should be administered through 
the medium of honey and sugar. Remedial measures 
described in connection with the Pittaja type of the 
disease should be employed both in the suppurated 
and the non-suppurated stages (of this type). 5. 

Treatment of Kaphaja Vriddhi :— In 

a case of the Kaphaja type of the disease, poultices 
with the heat-making f drugs (i.e , Vachadi, Pipp^lyadi 

* According to Gayadasa, the measures to be adopted should be those 
laid down in the Mis'raka chapter (Chap. XXV). 

t Some say that the heat-producing drugs are those comprised in the 
Aja-gandhddi group mentioned in the Mis'^raka chapter, Sutra Sth^nam. 



Chap. XIX.] CHIKITSA STHANAM. 441 

and Mushkakddl groups, etc.) pasted with cow's uHne 
should be applied. The patient should be made to 
drink a potion consisting of the decoction of Ddru- 
Haridrd mixed with the urine of a cow, and all the 
remedial measures with the exclusion of VimUpana 
(resolution by pressure) laid down under the treatment 
of the Kaphaja Granthi should be employed. The 
tumour should be opened (with a knife) when suppurated 
and the oil cooked with fdti, Arushkara^ Ainkota and 
Sapta-parna should be used for the purification 
(disinfection) of the incidental ulcer. 6. 

Treatment of IVledoja Vriddhi :— in 

a case of the Medoja (fat-originated) type of the disease, 
the affected part should be (lightly) fomented, * and 
plasters composed of drugs (of the roots) of the Surasddi 
group or of the S' iro-vircchana group (Ch. XXXIX. 
Sutra Sthana) pasted with the urine of a cow should be 
applied to it in a lukewarm state. The inflamed and 
swollen scrotal tumour, (lightly) fomented as before, 
should be tightened round with a piece of cloth. Then 
having encouraged the patient, the surgeon should open 
the tumour with a Vriddhipatra (knife) carefully avoid- 
ing the two testes (lying within the scrotal sac) and the 
median line of the perineum (Sevani). Then having 
carefully removed all morbid products (Medas) from its 
inside, Saindhava and sulphate of iron should be applied 
to the incised part, ani the scrotum should be carefully 
bandaged (in the manner of a Gophand bandage). After 
the proper purification (disinfection) of the ulcer, its 
healing should be effected with the application of an oil 

* The fomentation should be applied according to S'ivadas'a, with 
balls of cow-dung, etc., slightly heated. It should be noted in this 
connection that strong fomentations should not, in any case, be applied 
to the testes. 

56 



44^ 



THE SUSHRUTA SAMHITA. [Chap. XIX. 



cooked with Manahs'ild, Haritdla (yellow oxide of 
arsenic), rock-salt, and Bhalldtaka. y. 

Treatment of IVIutraJa Vriddhi : — 

In a case of an enlargement of the scrotun (hydro- 
cele) due to the derangement of urine, it should be first 
fomented and then a piece of cloth should be tightened 
rount it. A puncture should then be made in the bottom 
of the sac with a Vrihimukha instrument, on either side 
of the raphe of the perineum (Sevani). A tube open 
at both ends should be introduced (into the puncture) 
and the accumulated (morbid) fluid should be let out. 
The tube should then be taken off and the scrotum 
should be tied up with a bandage of the Sthagika 
pattern and the incidental ulcer should be purified and 
healed up with appropriate medicinal applications. 8. 

Treatment of Antra-Vriddhi : -A case 

of Antra-Vriddhi (hernia when strangulated) extending 
down to the scrotal sac (Kosha) should be given up as 
irremediable ; but, in the case of its not being so 
extended, it should be treated as a case of Vdtaja- 
Vriddhi. If the colon be found to have descended down 
to inguinal region (Vamkshana), it should be cauterized 
with a heated crescent-mouthed rod (Arddha-Chandra 
S'aldka) to prevent its descending down into the scrotal 
sac. A case of hernia that, in spite of all these pre- 
cautions, descends down into the scrotal sac (Kosha), 
should be given up as irremediable. The first finger of 
the hand opposite * the affected part {i.e., the affected 
testes) should be incised at its middle and cauterized, 

* Incision and cauterization should be performed in the thumb of 
the right hand, if the left testis is affected, and in case the affection is in 
the right testis, incision and cauterization should be made in the thunjb 
of the left hand. 



Chap. XIX.] CHIKITSA STHANAM. 443 

In cases of hernia (Antra-Vriddhi) of the Va(taja 
and of the Kaphaja type the affected part should 
be carefully cauterized in the above manner ; but in 
these two cases, the Sn^yu (ligamenls) should be cut 
off in addition (^before cauterization). In a case of 
Antra-Vriddhi the veins (S'ird) of the temples at the 
(upper) end of the ears on the opposite sides of the 
affection should be carefully opened avoiding the 
Sevani therein. 9-12. 

Treatment of Upadams'a * :— in cases of 

the curable type of Upadams'a, Sneha (oleaginous sub- 
stances) should be first applied, and the affected part 
should be fomented. Then the veins of the penis 
should be opened, or leeches should be applied (to the 
organ) for the elimination of the contaminated blood t 
(according as the affections are more or less severe), 13. 

General Treatments :— The system of the 

patient should be cleansed with both emetics and 
purgatives in the event of an excessive aggravation 
of the Doshas inasmuch as the local pain and swelling 
would subside simultaneously with the elimination of 
the aggravated Doshas from the system. Medicinal 
Vastis (enemas) should be injected (into the rectum) in 
the way of a Niruha-Vasti for the elimination of the 
aggravated Doshas, where the weakness of the patient 
would prohibit the application of purgatives. 14, 

Treatment of Vataja Upadams'a :— in 

a case of the Vataja type of the disease, drugs such as, 
Propaundarika, Yashti-inadhu, Varshdbhu, Kushtha, 
Deva-ddru^ Sarald, Aguru and Rdsnd^ should be used 
as a plaster (over the affected organ). Similarly 

* See note, Chapter XII., Nidana Slhanam. 

t Jejjata holds that leeches should be applied in a case of supejrficial 
Upadams'a. 



444 THE SUSHRUTA SAMHITA. tCbaP* XIX. 

plasters composed of Nichula, castor-seeds, and pul- 
verised wheat and barley grains pasted with Sneha 
(clarified butter, oil, etc.) should be applied lukewarm to 
the seat of the disease, which should also be affused 
with a decoction of the above-mentioned drugs, viz,, 
Prapaundarika, etc. 15. 

Treatment of Pittaja Upadams'a :— in 

a case of the Pittaja type of the disease, a plaster 
composed of Gairika, Anjana, Yashti-madhu^ S'drivd, 
Us'ira, Padmaka, (red) Chandana and Utpala mixed 
with a Sneha (clarified butter),* or that composed of 
Padma, Mrindla^ Sarjja^ Arjuna^ V etas a, and Yashti- 
madhu mixed with clarified butter should be applied to 
the affected organ which should be sprinkled with a 
solution of milk, clarified butter, sugar, sugar-cane juice 
and honey, or with a cold decoction of the drugs of 
Vatay etc. 16. 

Treatment of Kaphaja Upadams'a : - 

In a case of the Kaphaja type of the disease, a plaster 
composed of the barks of S^dla, As'va-karna, Aja-karna 
and Dhava pasted with Surd and mixed with oil, should 
be applied hot to the affected part. As an alternative, 
the drugs such as, Haridrd^ Ativishd, Mustd^ Sarald, 
Beva-ddru^ Patra, Pdthd, and Pattura should be used 
for similar purposes and the affected organ should 
be affused with a decoction of the drugs of the Su- 
ras ddi an d y4 'ragvadhddi groups. 17. 

The above remedial measures, viz., plasters, sprinkl- 
ing (Parisheka), blood-letting and Sams'odhana (^V., 
application of purgatives, emetics, etc) as well as those 



* According to S'ivad^sa the Sneha to be used In the plaster should 
be clarified butter washed a hundred times. 



Chap. XIX.} CHIKITSA STHANAM. 445 

described in the Sutra Sthdnam (and the first Chapter 
of the Chikitsita Sthdnam), should be resorted to 
in a case of (non suppurated) Upadams'a. The physi- 
cian should try his best to arrest the setting in of 
suppuration (in a case of Upadams'a) inasmuch as 
suppuration in (and consequent putrefaction of) the (local) 
veins, ligaments, skin and flesh would lead to the 
destruction of the organ (Dhvaja). An incision should 
be made as soon as suppuration would set in, and the 
pus and other putrid matters being drawn out, the 
incised part should be plastered with the paste of 
sesamum mixed with honey and clarified butter. 
The incidental ulcer should be washed with a decoction * 
of the leaves of Karavira, of Jdti and A'ragvadha, or of 
Vaijayanti and Arka. 18. 

The use of a medicinal plaster composed of the fine 
powders of Saurdshtra-mrittikd^ Gairikay Tuitha, 
Pushpa-Kdsisa, Saindhava^ Rodhra^ Rasdfijana^ Ddru- 
Haridrd, Haritdla, Manahs Ud, Harenukd and Eld^ 
mixed with honey is highly recommended in all cases 
of Upadams'a. 19. 

A decoction of the tender leaves of Jambu^ A'mra^ 
Sumanas, Nimba, S'vctd, and of Kdmboji f and the 
barks of S'allaki^ Vadara, Vilva, P aids' a, J mis' a and 
of the Kshiri trees, as well as Triphald should be used 
by the physician for constantly washing the ulcer. Oil 
cooked with the preceding decoction, with the Kalkas of 
Goji, Vidanga and Yashti-madhu, as well as with the 
different spices (Elad; group: should be used as the best 
remedy for the purpose of the healing up (Ropana) of 



• According to Chakralatta the five kinds of leaves should be 
separately used in the preparations of the decoctions for washing, 
t "M^shaparni" according to Gayadasa. 



44^ THE SUSHRUtA SAMHITA. [Chap. XIX. 

ain Upadams'a-ulcer of whatsoever type. The use of a 
pulverised compound composed of Svarjikd, Tuttha, 
Kdsisa, S'aileya, Rasdnjana^ and Manahs'Ud taken in 
equal parts arrests the extension of an ulcer and 
Visarpa. Cises of Upadams'a and Visarpa readily yield 
to the application of a pulverised compound of the 
ashes of Gundrd, Haritdla and Manahs'Ud. An 
(external) application of Bhrimgardja^ Jriphald and 
Danti mixed with the powders of copper and iron, 
destroys Upadams'a just as the thunder bolt of Indra 
(complelely) destroys a tree. 20. 

Treatment of Tridoshaja and Rak- 

taja UpadamS'a:— The medical treatment of the 
two kinds of Upadams'a due to the concerted action of 
the three Doshas as well as that due to the vitiated blood 
(Raktaja) should be taken in hand without holding out 
any definite hope of recovery. The above-mentioned 
medicines specific to the different Doshas should be 
combinedly applied in these cases in consideration of 
the nature and intensity of the Doshas specifically involv- 
ed in them. Now hear me discourse on the special 
treatment of Tridoshaja Upadams'a. It should be the 
same as in the case of a malignant ulcer (Dushta-Vrana). 
The putrid portion of the male organ should be cut off 
and the remaining portion should be fully cauterized (in 
the incised part) with a Jambvoshtha instrument, made 
red-hot in fire. Honey, and clarified butter should then 
be applied to the cauterized part, and medicinal plasters 
and oils possessed of healing properties should be 
applied to the incidental ulcer when it would be 
cleansed (disinfected). 21-22. 

Treatment of ^lipada:— In a case of 

Elephantiasis (Slipada) due to the action of the deranged 
and aggravated Va(yu, the vein (Sird) at a distance 



Chap. XIX.] CHIKITSA STHANAM. 447 

of four fingers above the instep (Gulpha) should be 
opened after an application of Sneha and Sveda * 
to the patient. Vastis should be employed when 
the patient has been (soothed and) restored to his 
former condition (with appropriate and nutritious diet, 
etc.V He should be made to take continuously for a 
month, a potion consisting of castor-oil mixed with 
(an adequate quantity of cow's) urine The patient 
should take rice as his diet with milk duly cooked with 
S'unthi. The use of the Traivrita Ghrita as well as 
cauterization of the affected part with fire is also recom- 
mended in such a case. 23. 

Treatment Of Pittaja ^Iipada:-ln a 

case of Pittaja type of Elephantiasis, the vein ^^ird) 
below the instep (Gulpha) should be opened. Medicinal 
remedies mentioned in connection with the treatmeiit 
of the Pittaja type of tumours (Arvuda) and of Erysi- 
pelas (Visarpa) as well as other Pitta-subduing remedies 
and measures should be employed-f-. 24. 

Treatment of Kaphaja ^Iipacla:-ln 

a case of the Kaphaja type of elephantiasis the principal 
vein (Sird) of the first toe should be opened by an 
experienced surgeon and the patient should be made 
to take at intervals the decoction (of the Kapha-sub- 
duing drugs) with honey. As an alternative, the patient 
should be advised to take the powders (Kalka) of Abhayd 
mixed with any officinal kind of urine. The affected 
locality should be constantly plastered with the paste 

* Chakradalta reads "^l^^iT*n^n'' in place of "^^^^i:^,:^^ g" 
meaning thereby that such Sveda and Upanaha should be applied 
before the incision of the vein. Gayadasa also supports this reading as 
is evident from Dallana's commentary. — Ed. 

t The panicle ««=^" in the text shows that Kapha-subduing remedies 
and measures should also be used in all these cases. 



448 THE SUSHRUTA SAMHITA. CChap. XIX. 

of Katukuy Amritd, S'unthiy Vidanga, Deva-ddru and 
Chitraka, or with Chitraka and Deva-ddru, An oil 
cooked with Vidanga, Markka, Arka, S'unthi, Chitraka, 
Deva-ddru^ Elakd and all the five officinal kinds of salt 
should be given him as a potion. Cooked barley is 
specially recommended as diet in the present case. 25. 
As an alternative, the patient should be made to 
drink a potion of mustard oil* or of the expressed juice 
of the leaves of /^//^/-A^^ra/^y^^ according to his capacity 
for the cure of Slipada. In the same wayf the juice of 
Putranjivaka should be prescribed by a physician 
after a due consideration as to the strength of the 
patient and of the time. The same juice {i.e., of Putran- 
jivaka) should be taken along with the juice of the 
bulbs of Kechuka with Pakima (vit) salt. 26. 

The Alkaline Remedies :— An alkali 

should be prepared from the ashes of Kdkddani, Kdka- 
janghd, Vrihati, Kantakdrikd, Kadamba-pushpa, Mandd- 
ri, Lamhd Sukanasd in the usual way by filtering them 
(twenty one times) after dissolving them in cow's urine. 
\ The expressed juice of Kdkodumharikd, Sukanasd and 
the decoction of Madana fruit should be mixed with 
the above alkaline preparation fand duly cooked in the 
manner of Kshira-pdka). Diseases, such as Slipada 

* Chakradatta reads "fq^cT ^"Iq ^%t" i" P^^ce of ^'fqtrT ^^^ §^' 
1^" which shows that the expressed juice of Puti-Karanja leaves should 
be taken with mistard oil an! not separately. Ddlana evidently supports 
this in his commentary. That Chakradatta's reading is the correct one is 
also evident from the next copulet which says that the expressed juice of 
Putranjivaka should be taken in the preceding manner. This ''preceding 
manner" evidently means "with mustard oil", and unless' we accept 
Chakradatta's reading, the expression would be unmeaning. — Ed. 

t It evidently means that the expressed juice of Putranjivaka should 
be taken with mustard oil — see last note. — Ed. 



Chap. XIX.] CHIKITSA STHANAM. 449 

(Elephantiasis), Apachi (ScrofuIa\ Gala-ganda Goitre), 
Grahani (chronic diarrhoea), aversion to food and the 
affections of all kinds of poison, yield to the iiiteriialuse 
of this alkaline preparation. An oil cooked with the 
aforesaid drugs, if used as errhines and anointments, 
will cure all the foregoing maladies as well as malignant 
ulcers (Dushta-vrana). 27. 

The ashes of the Dravariti^ Trivrit, Danti, Nili, 
Syamdy Saptald and S'amkhini should be filtered in the 
way of preparing alkalies after dissolving them in cow's 
urine. The solution, thus prepared, should be boiled 
with a decoction of Triphala. Taken internally it 
tends to act in the lower part of the body {ie , 
it moves the bowels). This medicine produces the same 
effect as the preceding ones. 28. 

Thus ends the nineteenth Chapter of the Chikitsita Sth^nam in the 
Sus'ruta Samhita which deals with the medical treatment of Vriddhi, 
Upadams'a and S'lipada. 



5; 



CHAPTER XX. 

Now we shall discourse on the medical treatment of 
the minor ailments or diseases (Kshudra-rog'al i. 

Treatment of Aja-gallika : -Leeches * 

should be applied to the affected part in a case of non- 
suppurated Aji-gallikai ; it should be subsequently 
plastered with the alkalies (Kshara) of oyster-shells, 
vSV/^!^)^;// (Svarjika), f and of Yava ; as an alternative, 
it should be plastered with the paste compound (Kalka) 
of S'ydmi, Langalaki and Pdthd. When suppurated it 
should b3 treated in the manner of an ulcer (Vrana). 2 

Treatment of Yava-prakhya, etc. :— 

Fomentation (Sveda) should be the first remedy to be 
resorted to in cases of Antrailaji, Yava-prakhya^, 
Panisi, Kachchhapi and Patsha^na-^ardabha (in their 
non-suppurated stages). They should then be plastered 
with the pastes (Kalka ' of Manahs'ild, Haritdla, 
Kushtha and Devaddrii An incision should be made 
as soon as suppuration would set in ; and the treatment 
shou'.d hi siaiUir t3 thxt of an ulcer. 3-4. 

Treatment of Vivrita, etc. : -The 

rem3dies mentioned in connection with the treatment 
of the Pittaja type of Erysipelas (Visarpa) should 
bi employed in casas of Vivritat, Indra-vriddha', 
Gardabhi, Jatla-gardabha, Irivelli, Kaksha(, Gandha- 
natmni and Visphotaka. Clarified butter cooked with 

* Gayadasa explains that a non-suppurated Aja-gallikSb should 
be first plastered with Yava-kshara, oyster-shells and Saurashtri. Leeches 
should be next applied to it. 

t Chakradatta reads * 'Tif^-^TTT^^WTT &c." in place of **^%gfl- 
tm-^K &c.", evidently, after the commentary of Gayaddsa 



Chap. XX.J CHIKITSA STHANAM. 451 

the drugs of the Mad/mm (K^kolyadi) group should 
be applied in healing up the ulcers in the suppurated 
stages. 5 . 

Treatment of Chipya, etc :— in a case 

of Chipya, the affected part should be first washed* 
with hot water and (the incarcerated pus, etc.) 
drained (Visrava) by cutting it away (with a knife). 
Then after anointing it with (the oil known as) the 
Chakra-taili it should be dusted over with the 
powders of Sarja (resin) and duly bandaged. If 
this process of treatment fail, the affected part should 
be cauterised with fire and an oil cojked with (a 
decoction of) the drugs of the Madhura (KdkolyddiJ 
group should be applied to heal (the incidental ulcer). 
The same course of treatment should also be adopted 
in a case of Ku-nakha (bad nail). 6-y. 

Treatment of Vidarika :— in a cae of 

Vida'rikat, the affected part shou'd be first anointed 
(with oleaginous substances) and then fomented. It 
should then be rubbed (with the fingers) ; and a piaster 
composed of Naga-Vrittika, Varshdbhu and Vilva- 
roots, well pasted together, should be applied to it. 
Purifying and disinfecting (Sams'odhana) remedies 
.should b3 employed as soon as the affected part would 
be found to have been changed into the state of an 
ulcer (Vrana\ and it should then be healed up with the 
application of an oil cooked with the decoction of (the 
drugs of the Kashdya (Nyagrodhadi) and Madhura 
(Kakolyadi) groups, In the n^n suppurated stage of 
Vidarika, the vitiated blood therein should be let out 
by means of Prachchhana (scarification), or by applying 
leeches. The affected part should then be plastered with 

■* Vrinda and Chakradalta prescribe fomentalion (Sveda), and not 
washing, with hot water and they do not prescribe secretion (Visrava). 



452 THE SUSHRUTA SAMHITA. [Chap. XX, 

the roots of the Aja-karna and of the Paldsa pasted 
together. A case of fully suppurated Vidsirikai should 
be lanced and plastered with a paste compound oi Patola^ 
Pichumarda and sesamum, mixed with clarified butter 
and should then be duly band-iged. The incidental ulcer 
should then be washed with a decoction (of the barks > 
of the Kshiri trees and Khadira, Healing remedies 
should be applied after it has been properly purified 
(disinfected) 8-9. 

Treatment of ^arkar^rvuda, etc. :— A 

case of Sarkarairvuda should be treated like that of 
an Arvuda (tumour) of the fat-origined type. Cases of 
Kachchhu, Vicharchikai and Pa^mai should be treated 
in the manner of a Kushtha. A medicinal plaster 
composed of Siktha (wax), S'atdhvd and white 
mustard seeds, or of Vachd, Ddrn-haridrd and mus- 
ta»'d seeds, pasted together, should be applied (to the 
seat of the disease). As an alternative, Naktamdla 
(Karanja) oil, or Sdra-taila * boiled with (the drugs of) 
the Katuka (PippalyAdi) group should be applied for 
anointing purposes. lo-ii. 

Treatment of Pstda-d^tri :— In a case of 

Ps^da-datn, the prescribed vein should be opened, and 
the affected part should be treated with fomentations 
a'ld unguents, t The affected part should be plastered 
with (an ointment composed of) wax, lard, marrow, 
powder of Sarja (resin),t clarified butter, Yava-Kshdra 
and Galrika, 12. 

* By "Sdra-taila" is meant the oil pressed from the Sdra (essential 
parts) of S'ims'ap^, Aguru, Sarala, Deva-d^ru and such other treef. Some, 
however, read "Sarala-laila" in place of "Sdra-taila."— Dallana. 

t According to Dallana and S'ivadasa, fomentations and unguents 
should be first applied, and the vein should be next opened. 

X Chakradatta also prescribes a similar remedy, but there he does 
not read "Sarja" ^nd <• Gairika."— Ed. 



Chap. XX.] CHIKITSA STHANAM. 453 

Treatment of Alasa and Kadara :— in 

a case of Alasa, the legs should be sprinkled With Arandla 
(a kind of Kdnjika) ; and a plaster compused of stsamum, 
Nimba leaves, sulphate of iron {Kdsisa), Haritdla and 
Saindhava, or of Haritaki pasted with the decoction 
of Ldkshd (Ldkshd-rasa) * should be applied to the 
affected parts. Blood-letting should also be resorted to. 
As an alternative, mustard oil boiled with the expressed 
juice o{ Kantakdri should be applied to them or the 
affected localities should be rubbed or chafed (Piati- 
sdrana) with a pulverised compound of sulphate of iron 
(Kdsisa^, Gorochand and Manah-s'ild. In a case of 
Kadara, the seat of the disease should be scraped off 
(with the aid of a knife) and cauterised with (the 
application of) heated oil f 13-14. 

Treatment of Indra-lupta :- in a case 

of Indra-lupta (baldness or Alopecia), the bald part 
or seat should be anointed and fomented, and then 
bleeding (by venesection) should be resorted to, after 
which a plaster composed of Manah-s'ild, Kdsisd, Tuttha 
and Maricha^ or of Kutanfiatd and Deva-ddru pasted 
together, should be applied to it. As an alternative, it 
should be deeply scraped and constantly kept covered 
with a paste of Gu7ijd-SQQds. As an alternative, 
Rasaiyana medicines should be administered for its 
cure. An oil cooked with Mdlati, Karavira, Chitraka 
and Naktamdla is highly efficacious in curing a case of 
Alopecia, if used as an unguent. 15. 

Treatment of Arumshika : Blood-let- 

* Chakrapani reads ''^^grm^rr.^T^q:''' '" P'ace of "^l^j^^VRH 
iplfq". Sivad^sa explains <»^:^;" as * jyj^T^; "—Ed. 

t Chakradatta prescribes caulerisalion with fire as well, in such j» 
case.-— Ed. 



454 THE SUSHRUTA SAMHITA. [Chap. XX. 

ting* from the affected patt should be first resorted to in 
a case of Arumsliikafc ; and it should then be affused 
with the decoction of Nimba Medicinal plasters pre- 
pared with the R >sa (liquid) pressed from horse-dung, 
mixed with Saindhava, should be applied to it. ^s an 
alternative, it should be plastered with the paste com- 
pound (Kalka) of Haritdla Haridrd., Nimba and Patola, 
or with that of Yasthi-madhu^ Nilotpala, Eranda, and 
Mdrkava. l (\ 

Treatment of Darunaka, etc.:— Anoint- 
ment and fomentation of the diseased patches are the (pre- 
liminary, remedies in a case of Dairunaka, after which 
bleeding should be effected by opening the vein in the 
forehead Remedial measures such as, Avapida-Sirovasti 
and Abhyanga (anointment) should be employed as 
well ; and the affected parts should be washed with the 
alkaline solution of burnt Kodi'ava weeds. Measures 
for arresting the premature greyness of hair (Palita) 
will be described later on (in the Mis'raka Chapter 
XXV). Curative plasters and remedies, etc , mentioned 
in connection with the treatment of Kushtha should be 
employed in cases of Masurikat; or those, laid down 
under the treatment of Erysipelas iVisarpa) originated 
through the concerted action of the deranged Pitta and 
Kapha should as well be u-ed. 17-19. 

Treatment of Jatu-mani, etc. :— The 

seats of affection should be scraped (with a knife) 
and gradually and judiciously cauterised*)* by 
applying an alkali or fire in cases of Jatu 
mani (congenital moles), Mas'aka and Tila-kailaka 

* According to Chakradaila blood-letling should be resorted to in 
such cases only by means of venesection, or with leeches. 

t The cauterisation should be effected with an alkrili, when the 
disease is superficial and with fire when it is deep-seated, 



Chap. XX.] CHIKITSA STHANAM. 45 J 

(freckles) An opening of the local veins in the 
temporal region, etc., should be effected in cases of 
Nyachchha, Vyanga and Nilikai, in accordance with the 
prescribed rules. The aff'ected parts should be rubbed 
(^with Samudra-phena, etc.) and plastered with the barks 
of A'^V/m trees.pasted with milk ; or with Vald, Ati-valdy 
Yashtimadhu and Rajani^ pasted together. As an 
alternative, plasters composed of Payasyd^ Aguru and 
Kdliya pasted together with Gairikay or of a tooth 
of a boar pasted with clarified butter and honey, or of 
Kapittha and Rdjddana pasted together, may also be 
used with benefit 2021. 

Trcatmcntof Yuvana-Pidaka, etc:.— 

Emetics are specially efficacious in cases of Yuvakna- 
pidakaL i pimples) which disfigure the face in youth. 
The application of medicinal plasters composed of 
Vachd, Lodhra^ Saindhava and (white mustard seeds 
or of Kicstumburu, Vachd, Lodhra and Kushtha 
pasted together is also recommended. In a case 
of Padmini-Kantaka, a decoction of Nimba bark 
should be given as an emetic, and the patient should 
be made to drink a potion of clarified butter cooked 
with a decoction of Nimba and mixed with 
honey. A decoction * of Nimba and Aragvadha 
should be used for chafing (Utsadana) the diseased 
locality. 22-23. 

Treatment of Parivartika, etc.:— in a 

case of Parivartikai ^retroflexion of the prepuce) the 
glans penis should be rubbed with clarified butter and 
duly fomented, and Sailvana and such other V^yu- 
subduing plasters (Upan^ha) should be applied for three 

* Chakrapani prescribes the powders (^j^eff) in place of the decoction 
(in^) of Nimba and Aragvadha. He also reads *'^^^" in place 
of '*^(5T^t"> but here they mean the same thing. — Ed. 



456 THE SUSHRUTA SAMHITA. [Chap. XX. 

or five days. Then having lubricated the part (with 
Ghrita), the glans penis should be gently pressed and 
the prepuce should be smoothly drawn over the glans 
penis^ so as to cover it entirely within its fold. The pre- 
puce, being so drawn, should be fomented with warm 
poultices. Vayu-subduing Vastis (Clysters) should be 
employed and emollient diet should be prescribed 
(during the course of the treatment;. A case of Ava- 
patikab should be similarly treated, after a due considera- 
tion of the nature and intensity of the Doshas involved 
in the case. 24-25. 

Treatment of Niruddha-Prakas'a :— 

In a case of Niruddha-Prakas'a (constriction or stricture 
of the urethra', a tube ^open at both ends) made of iron, 
wood, or shellac should be lubricated with clarified butter 
and gently introduced into the urethra. The marrow 
or lard of a boar, or of a porpoise, or the Chakra-taila, 
mixed with Vdyu-subduing drugs should be sprinkled 
over the affected part. Thicker and thicker tubes 
should be duly introduced into the urethra every 
third day. The passage should be made to dilate in the 
aforesaid manner, and emollient food should be given 
to the patient. As an alternative, an incision should 
be made (\x\\.o the lower part of the penis), avoiding the 
sevani (raphe of the perineum'\ and it should be treated 
as an incidental ulcer Sadyo-vrana\ 26. 

Treatment of Sanniruddha-Guda, 
etc. ;- Cases of Saimiruddha-Guda (stricture of 
the anus), Valmika and Agni-Rohini should be duly 
treated with regard to the nature and intensity (of the 
Doshas engendering the disease , but without holding out 
any definite hope of recovery. The treatment of a case 
of Agni-Rohini should be like that of Visarpa (Erysi- 
pelas), while the remedial measures, mentioned in connec- 



Chap. XX.] CHIKITSA STHANAM. 457 

tion with Niruddha-prakas'a, should be employed in a 
case of Sanniruddha-Guda. 27. 

Treatment of Valmika : -The diseased 

patches should be scraped ofif in a case of Valmika and 
cauterised with fire or with an alkali ; while the purifica- 
tion and healing up (of the incidental ulcerj should 
be effected as in the treatment of an Arvuda 
(tumour;. A case of Valmika appearing in any part of 
the body other than a Marma, and not of a considerable 
growth should be duly treated with venesection after the 
application of Sams'odhana measures (purgative, emetic, 
etc.;. The affected part should be plastered (Pralepa) 
with a medicinal compound composed of the roots of 
{Vana-) Kulattha, Arevata, Danti and S'ydmd, pasted 
together with Guduchi^ rcck-salt, Palala (pastes of sesa- 
mum) and powdered barley. It should be poulticed 
(Upan^ha) with the same compound, well mixed with 
clarified butter and made lukewarm (in case suppu- 
ration be desired). When found to be fully suppu- 
rated, the course of the pus- channels should be 
ascertained by an experienced surgeon. The ulcer should 
then be opened (with a knifed and cauterised, and after 
being fully purified of the putrid flesh (\\\ its cavity), 
it should be again cauterised with an alkali. Healing 
(Ropana) remedies should be applied to it after it 
has been found to be thoroughly cleansed Nimba- 
oil cooked with Sumanas (Jdti leaves, Granthi, Bhalld- 
taka, Manah s'ild, Kdldnusdri, small Eld, Aguru and 
red Chandana should be applied with advantage 
to heal up the vincidental ulcer in a case of) Valmika. 
A patient suffering from an attack of Valmika appearing 
either on his hands or feet and attended with swell- 
ing and a large number of cavities should be aban- 
doned by a wise physician. 28. 

58 



458 THE SUSHRUTA SAMHITA. [Chap. XX. 

Treatment of Ahi-putansi, etc.:— in 

the treatment of an infant laid up with an attack of 
Ahi putana( the breast-milk of its mother or nurse should 
be first purified. Cases of Ahi-putana yield to the use of 
a potion of clarified butter, cooked with Triphald^ Rasdn- 
jana and Patola leaves, and a decoction of Triphaldy 
Kola and Khadira should be used (as a wash) to heal 
the ulcer. Plasters composed of sulphate of iron, Goro- 
chandy sulphate of copper {Tutthd), Haritdla and Rasdn- 
jana, pasted together with Kdnjika, or of Vadari bark 
and rock-salt, should be applied (to the diseased locality*. 
It should be dusted as well with the pulverised com- 
pound of a burnt earthen pot and sulphate of copper. 
The preceding measures should be adopted in cases 
of Vrishana-Kachchhu as well. 29-30. 

Treatment of Guda-Bhramsa : -in a 

case of Guda-Bhramsa, the protruded part should be 
fomented and lubricated with Sneha.* It should then be 
gently re-introduced. The region of the anus should 
then be bandaged with apiece of hide m the manner of 
a Gophana Bandha, with an opening in it (lying imme 
diately below the anus), so that it may not in any way 
interfere with the emission of Vayu. The affected part 
should then be constantly fomented. A quantity of milk, 
Mahd-pancha-mtila and the body (flesh) of a mouse, 
bereft of its entrails should be first boiled together (with 
water). An oil cooked with the milk thus prepared 
(with water) and the Vayu-subduing drugs should 
be administered as drink and unguents. By these 
measures the most difficult cases of prolapsus aui would 
be cured. 31-32. 

* According to S'lva-dasa, cow's fat only should be used. 
Thus ends the twentieth Chapter of the Chikitsita Sthanam in the 
Sus'ruta Samhitji which deals with the treatment of minor ailments. 



CHAPTER XXI. 

Now we shall discourse on the medical treatment of 
the Sores on the penis produced by the Suka, a kind of 
poisonous insect (S'uka-Rog^a). r. 

Treatment of Sarshapi, etc. :— In a 

case of the Sarshapi type of the disease, the affected 
(ulcerated) part should be scarified and dusted with 
the (powdered) dru^^s of an astringent taste (as de- 
scribed in the Mis'raka chapter), and an oil, cooked with 
(the Kalka and decoction of) the same drugs, should be 
applied for healing purposes. In a case of the Ashthi- 
likai type of the disease, the skilful physician should 
apply leeches to the seat of affection. In case the swelling 
does not still subside, it should be removed and treated 
as a KaphajaGranthi (glandular swelling). A GrantM 
type of the disease should be constantly fomented in the 
manner of Naidi-Sveda, and should be poulticed with a 
lukewarm medicinal compound mixed with a profuse 
quantity of Sneha (oil). 2-4. 

Treatment of KumbhiksC, etc. :— An 

incision should be made into the suppurated seat of 
affection in a case of the Kumbhikai type of the disease, 
and the incidental ulcer should be purified (disinfected) 
and healed up with the application of the oil, cooked 
with Triphaldy Lod/tra, Tindtika and Amrdtaka^ In 
the Alaji type of the disease, the affected part should 
be bled by applying leeches to it and should then be 
affused with a decoction of th? astringent drugs. An 

* S'lva-dasa in his commentary on Chikra-datta quotes this couplet 
from Sus'ruta, but there he reads '^fi^§f^^ in place of ^ Tl?| flli '^? t^*^ is to 
say, he says that A'mra should be used in place of Amrataka. He 
further adds that the stones of Amra and Tinduka fruits should be taken, 



460 THE SUSHRUTA SAMHITA. [Chap. XXI. 

Oil, cooked with the decoction of the same drugs, should 
be used to heal up the (incidental) ulcer. 5-6. 

Treatment of IVIridita, etc. :— in the 

Mridita type of the disease, the affected part should be 

affused with tepid Valai oil and poulticed with a 

lukewarm plaster (Upanaha) of the drugs of the Mad- 

hura (Kdkolyddi) group, pasted and mixed with clarified 

butter. Leeches should be speedily applied to the condyl- 

omatous growths (Pidakai) in a case of Sammudha- 

Pidakat. In cases of suppuration, they should be opened 

and plastered with honey and clarified butter. In a case 

of Avamantha, the growths (Pidakd) should be opened, 

when suppurated, and healed up with the application of 

an oil, cooked with Dhava, As va-Karna, Paitanga, 

S'allaki and Tinduka. 7 — 9 

Treatment of Pushkarika, etc. :— in a 

case of Pushkarikai, all kinds of cooling measures should 
be applied and the vitiated blood should be extracted 
by applying leeches. The affected part should be 
subsequently affused with clarified butter. In a 
case of the Sparsa-ha(ni type of the disease, blood 
should be let out and plasters (Pradeha) of Madhura 
(Kdkolyddi) drugs should be applied. The affected part 
should be affused with a very cold compound of milk, 
clarified butter and the expressed juice of sugar cane. 
In the type of the disease known as Uttama(, the 
Pidakis ^condylomatous growths) should be removed 
with the help of a Vadisa instrument, and powders of 
astringent drugs with honey should ba applied to the 
seat of affection. 10 — 12. 

Treatment of Sata-ponaka, etc.: — in 

a case of the Sa,ta-ponaka type of the disease, the affect- 
ed part should be scarified and the measures laid down 
in coniection \yith Rasa-Kriyd should be resorted to. 



Chap. XXI.] CHIKITSA STHANAM. 46 1 

After this, an oil, cooked with the Prithak-pamyddi 
drugs* should be likewise applied to the seat of the 
disease.) The medicinal treatnnent, in a case of Tvak- 
paika, should be the same as described in connection 
with Erysipelas (Visarpa). The remedial measures, 
laid down under the head of Rakta-vidradhi, should be 
employed in a case of the SDnitairvuda type of the 
disease. 13-14. 

General Treatment :— Remedies such as 

medicinal decoctions, pastes (Kalka\ medicated clarified 
butter, powders, Rasa-Kriyd, etc., and the measures for 
purifying and healing (incidental sores or ulcers\ should 
be employed with due consideration to the nature 
and intensity of the aggravated Doshas involved in the 
case. The application of specifically prepared medicated 
clarified butter, purgatives, blood-letting and light 
diet should be similarly prescribed. f 15. 

Prognosis : -The medical treatment of the 
patient affected with any of the following types of the 
disease, viz., Arvuda, Mdmsa-paka, Vidradhi and Tila- 
Kdlaka should be undertaken without holding out any 
definite prospect of recovery. 16. 

Thus ends the twenty-first Chapter of the Chikitsita Sthdnam in the 
Suslruta Samhit^ which deals with the treatment of S*uka-Roga. 

* For Ra?a-kriya and the Prithak-pamyldi drugs, see Chapter 
XXXVI— Sulra-sthdna. 

t This seems to be the general treatment of all the types of S uka- 
Roga. 



CHAPTER XXII. 

Now we shall discourse on the medical treatment 
of the affections of the mouth (IVIukha-Rog'a). i. 

Treatment Of Vataja Oshtha-kopa:— 

In a case of inflammation of the lips (Oshtha-Kopa) 
due to the action of the deranged Vaiyu, the affected 
part should be rubbed with (an ointment composed of) 
the four kinds of lardacious (Sneha) substances mixed 
with wax. Fomentations in the manner of Naidi-Sveda 
should also be resorted to by an intelligent physician. 
Applications of the Sativana poultices and those of the 
medicated oils, possessed of the virtue of subduing the 
deranged Vayu, as errhines and Mastikya (Siro-vasti) 
are also recommended. The lips should be treated 
with the powder composed of S'riveshtaka* Sarja rasa^ 
Sura-ddru, Guggulu and Yashti-madJiu. 2-4. 

Treatment of Pittaja Oshtha-kopa, 

etc.:— In a case of Oshtha-kopa of traumatic origin, 
(AbhighsLtaja) or one due to the deranged action of the 
blood (Raktaja) or of the Pitta, bleeding of the affect- 
ed part should be effected by the application of leeches 
and all the measures and remedies (Samsodhana and 
Samsamana) mentioned in connection with the treatment 
of the Pitta-Vidradhi should be likewise employed. 5- 

Treatment of Kaphaja Oshthakopa : 

— Theu^e of medicated Siro-virechana(errhines\ fumiga- 
tions, (Vairechanika Dhuma), fomentation and (Sveda) 
Kavala (gurgles), prepared from the Kapha -subduing 
drugs should be recommended after blood-letting in the 
Kaphaja type of Oshtha-kopa. The swollen and inflamed 
lips should be treated (Pratisirana) with a compound con- 

* y^gbhata reads " ^^f^^ » i. e., wax, in place of tiflf^^pfT I 



Chap. XXII.] CHIKITSA STHANAM. 463 

sisting of TrikatUf Sarjikd-kshdra, Yava Kshdra and 
Vid-lavana vblack-salt) * pounded together and made 
into a thin paste with the admixture of honey. 6. 

Treatment of lYIedoJa Oshtha-kopa : 

— In a case of the fatty type of Oshtha-kopa, the 
affected part should be fomented and opened (when 
suppurated) ; and should then be purified and 
cauterised with fire, A paste compound of Priyangu, 
Triphald, Lodhra and honey should be rubbed over the 
affected part (Prati-sArana). These are the remedies for 
the curable types of Oshtha-kopa, 7-8. 

Treatment of the Diseases of Danta 

-lYIula :— Now we shall describe the treat- 
ment of the affection of the r(jots of the teeth (Gingi- 
vitis). In a case of the Sitatda type of the disease, 
the gums should be first bled and a decoction of 
Sarshapa^ Ndgara, Triphild and Musta f mixed 
with Rasdnjana should then be used as gurgles. 1 he 
gums should be plastered (Pralepa) with Priyangu, 
Musta and Triphald and (clarified butter, cooked with) 
the decoction of Triphald, Madhuka, Utpala and 
Padmaka should be used as an errhine. In an acute 
case of Danta-Pupputaka, the gums should be first bled 
and then rubbed (Prati-sarana) with the five officinal 
kinds of salt and Yava-Kshdra mixed with honey. 
The use of errhines (Siro-virechana), medicated snuffs 
(Nasya) and demulcent food is recommended. 9-10. 

Treatment of Danta-Veshta, etc. :— 

In a case of Danta-Veshta, the swelling should be first 
bled and then rubbed with a pulverised compound of 
Rodhra, Pattanga, Yashti-madhu and Ldkshd mixed with 
a profuse quantity of honey. A decoction of (the bark 

* Vrinda and Chakrapani do not read Vid-lavana, 

t Vrinda and Chakra-datta do not read Musta, nor Rasanjana. 



4^4 THE SUSHRUTA SAMHITA. [Chap. XXII. 

of) the Kshiri trees, mixed with sugar, honey and clari- 
fied butter (as an after-throw) should be used as gurgles 
(Gandusha). Clarified butter, cooked with the drugs 
of the Kdkolyddi group with ten times its own weight of 
milk, should be used as snufi* (Nasya). In a case of 
Saushira, the affected parts, after being properly bled, 
should be plastered (Lepa) with Lodhra, Musta and 
Rasdnjana, pounded together and mixed with honey. 
A decoction of the Kshiri trees should be used as 
gurgles (Gandusha), and clarified butter cooked with 
the paste-compound of Sdrivd, Utpala, Yashti-madhu, 
Sdvara {hod\ir?^\ Aguru, (red) Chandana and ten times 
its own weight of milk should be recommended 
as an errhine. 1 1-12. 

Treatment of Pari-dara, etc. :— In a 

case of Pari-dara the treatment should consist of the 
remedies described in connection with Sitada* In a 
case of Upa kusai as well,* the system of the patient 
should be cleansed both ways ^by means of emetics and 
purgatives), and his head should be cleansed with Siro- 
virechana. The affected part (in a case of Upa-kus'a) 
should, in addition, be bled (by rubbing it over) with the 
leaves of the Kdkodtimbarikd, or of the Goji, or with 
the application of a medicinal compound composed of 
the five officinal kinds of salt and Trikatu mixed with 
honey. Tepid watery solutions-|- of Pippali^ (white) 
Sarshapa^ Ndgara, and Nichula fruits should also be 
used as gurgles (Kavala). The use of clarified butter 
cooked with the drugs of the Madhuta (Kdkolyddi) 

■* This shows that cleansing the system by means of emetics and 
purgatives, as well as with S'iro-virechana should be resorted to in a case 
of Pari-dara as well. 

t The solution may be prepared with the drugs taken together or 
separately. 



Chap, XXir.J CHIKITSA STHANAM. 465 

group as errhine (Nasya) and gurgle (Kavala) is also 
recommended. 13-14. 

Treatment of Danta Vaidarbha, etc.: 

—In a case of Danta-Vaidarbha, the regions about 
the roots of the teeth should be cleansed by open- 
ing them with a (MandaUgra) instrument and sub- 
sequently treated with alkaline applications. Cooling 
measures should also be resorted to ^during the treatment 
of this disease). In a case of Adhika-danta, the 
additional tooth should be uprooted and removed ; 
then (in order to arrest the bleeding, if. any), the part 
should be cauterised with fire, and then an experienced 
physician should apply the remedies mentioned under 
the head of worm-eaten teeth (Krimi-dantaka), 15-16 

Treatment of Adhi-mamsa :— in a case 

of Adhi-mamsa, the additional fleshy growth about 
the roots of a tooth should be removed (with 
a knife) and treated with a compound of Vachd, 
Tejovati, Pdthd, Sarjikd and Yava-kshdra, pasted 
together with honey. Powdered Pippali^ mixed with 
honey, should be used as a gurgle (Kavala); and a decoc- 
tion of Patola^ Triphald and Nimba for washing the 
affected part. Errhines (Siro-virechana) and inhalation 
of Vairechana smoke, (that lead to the secretion of 
mucus from the head), would likewise prove efficacious 
in such cases. 17. 

Treatment of Danta- Nad i :-ln a case of 

Danta-Nadi, the treatment of Nadi (Sinus) about the 
teeth is identical with that of sinus in general. The 
specific remedial measure, however, is that the gum of 
the affected tooth should be incised, and the tooth should 
be extracted, if it be not in the upper jaw. The affected 
part should then be purified and cauterised with an 
alkali or fire. Hence in a case of Sinus (Nddi), a com- 

59 



466 THE SUSHRUTA SAMHITA. [Chap. XXH. 

plete extraction of any fragment of the broken bone, 
or tooth, is essentially necessary (for its cure), inas- 
muc'i as, if left uiextracted, it may cause the sinus to 
affect (run below I the jaw-bone. If the affected tooth 
be in the upper jaw, and if it be found to be firm and 
steady at its roots, though attended with tooth-ache,* 
it should not be extracted, inasmuch as it might 
produce an excessive haemorrhage from its roots, 
and usher in blindness, facial paralysis, or other 
dangerous affections (such as convulsion, etc.) due 
to the excessive loss of blood. Hence in the case 
of a looseness of such a tooth in the upper jaw, it should 
not be extracted A decoction f of Jdti, Madana, 
Svddu'Kantaka and Khadira should be used to wash 
the mouth An oil cooked witn Jdti, Madana, 
Katuki, Svddu-Kantaka. Yashti-madhu, Rodhra, 
Manjishthd and Khadira should be used to cleanse and 
heal a sinus invading the roots of a tooth. The re- 
medial measures to be employed in the diseases affecting 
the roots of the teeth have thus been described above. 



* Both Vrinia an I Chakr^datta quote this passage from the text, but 
b )th of th-m r-a 1 "igrffijct ^^jf^W^" (excessive bleeding takes place) in 
place of "^^ 1%T?:^5q%" ('^ '^ be found to be firm and steady at its roots, 
though attended with tooth-achi) S'ri-kantha Datta, again, in his com- 
mentary quotes another reading "^r^S%^^^" ('fit be loose in its 
sockets and be extracted with its roots). In our humble opinion, however, 
the current reading of the text seems to be the correct one, inasmuch as 
both the leadings quoted above seem to be redundant in the presence of the 
two following sentences "?:iiTt%^^f[ " and ''^^?t^tK ^5ff'..."— Ed. 

t According to S'rikantha and S'ivadasa, it appears that the applica- 
tion of this decoction as a wash is not to be found in all editions of the 
Sus'ruta Saiuhita, Imt they say that it is found only in Jejjata's reading. 
Jejjaia*s reading and explanation seem to be correct and have been 
followed by us in the translation.— Ed, 



Chap. XXn.] CHIKltSA STHANAM. 4^7 

We shall now proceed to describe the medicinal remedies 
to be employed in the diseases which confine them- 
selves exclusively to the teeth 18-21. 

Treatment of the diseases of Tooth 
proper :— A case of Danta-harsha yields to the 
use of any lukewarm Sneha * or the Traivrita-ghrita 
(mentioned in Chapter V), or of the decoction of the 
Vdyu-subduing drugs as gurgles (Kavala). An applica- 
tion of Snaihika Dhuma (^emulsive fumes) and the use 
of snuff (Nasya), emulsive articles of food, meat soups, 
gruel prepared with meat (Rasa-Yavdgu), milk, milk- 
cream, clarified butter, Siro-vasti and the other Vayu- 
subduing measures generally prove efficacious. 22. 

In a case of Daata Sirkarai (^Tartar-calcareous 
deposits on the teeth), the deposit should be removed 
in such a way as not to hurt the roots of the tooth, after 
which the part should be dusted (Prati-sarana) with 
powdered Ldkshd with honey. All the remedies men- 
tioned in connection with the treatment of Danta- 
harsha may as well be employed in this disease. 23 

Treatment of Kapalika, etc. : These 

remedies are also efificacious in a case of Kapailikai 
(caries of the tooth) which is extremely hard to cure. 
In a case of Krimi-Danta (worm-eaten tooth) found to 
be firm and unloosed (in its socket), the affected tooth 
should be fomented, and the accumulation [i. e., the pus, 
blood, etc.) should be removed. It should then be treated 
with some Vdyu-subduing errhines of the Ava-pida 
form and with emollient gurgles (Gandusha), as well as 
with plasters, prepared with Varshdhhu and the drugs 
of the Bhadra-Ddrvddi group and with a diet of 
emulsive articles of food. In the case, however, where 

* All the four kinds of Sneha should be used separately or 
combinedly. 



468 THE StJSriRUTA SAMHITA. [Chap. XXlI. 

the tooth is found to be loose (in the socket\ the 
loose tooth should be extracted, and the cavity 
cauterised with fire or an alkali (for the purpose 
of arresting the bleeding). An oil cooked with the 
pastes (Kalka) of Viddri, Yashti-madhu, S'ringdtaka, 
and Kas'eruka and with ten times its own weight of 
milk should be administered as an errhine (in such 
cases). The course of treatment in a case of Hanu- 
moksha is the same as in one of facial paralysis. 24-27. 
A person suffering from any affection of the teeth 
should refrain from taking acid fruits, cold water, dry 
(Ruksha) food, excessively hard articles of food and 
from brushing his teeth (with a twig). The treatment 
fof the curable types of tooth-diseases has be^n thus 
described above, we shall now (proceed to) describe the 
treatment of the curable types of tongue-diseases. 28 29. 

Treatment of Tongue-diseases :— In 

the Vaitaja type of Jihvai-kantaka (,Papilla), the 
treatment should be the same as in the case of 
Vdtaja Oshtha-kopa. In the Fittaja type (of Jihva 
kantaka), the vitiated blood should be made to secrete 
from the affected organ by rubbing it with any article of 
rough surface (such as the leaves of S' dkhotaka, etc.), and 
the drugs of the Madhura (Kakoly^di) group should be 
used for gurgles and errhines, as well as for being rubbed 
over (Prati-sarana) the affected organ. In the Kaphaja 
type (of Jihva-kantaka). the organ should be bled by 
scarifying it (with a Mandala patra and such other 
instrument) ; it should then be rubbed with the 
powders of the drugs of the Pippalyddi group mixed 
with honey. A compound of powdered white mustard- 
seed and Saindhava should be administered as 
gurgles (Kavala), and the patient should be made 
to take his food with the soup of Patola, Nimba, 



Chap. XXII.3 CHIKITSA STHANAM. 4^9 

and Vdrtdku mixed with (a liberal quantity of) 
Yava-Kshdra 30. 

Treatment of Upa-Jihva :— In a case of 

Upa-jihvai(Raaula),the affected part should be scarified 
and rubbed with an alkali, and the patient should be 
treated with errhines (Siro-vireka), gurgles (Gandusha) 
and inhalations of smokes (Dhuma). The treatment of 
the tongue diseases has been thus described above. 
We shall now describe the medical treatment of the 
affections of the palate (Tdlu-gata Roga). 31-32. 

Treatmentof the Talu-gata diseases: 

— In a case of Grala-s'andika^, the Sundik^ (protuber- 
ance) should be drawn out along the tongue with the 
help of the thumb and the second finger of the hand, or 
with a Samdamsa (forceps) and then cut off with a Man- 
dalagra instrument. But it should be severed neither 
more nor less than three-quarters of the append- 
age, inasmuch as profuse haemorrhage might follow 
an excessive incision, and death might result therefrom ; 
whereas, a case of lesser severance is usually found to 
be attended with swelling, excessive salivation, somno- 
lence,* vertigo, darkness of vision, etc. Hence a 
surgeon, well-versed in the science of surgery and well- 
skilled in practical operations, should carefully operate 
a Gala-s'undika (with a knife) and subsequently adopt 
the following measures. The incidental ulcer should 
b3 treated with the pulverised compound of Maricha^ 
Ati'vishd.Pdthd, Vachd, Kushthadind Kutannata^ mixed 
with honey and rock-salt. A decoction of Vachd, 
Ati-vishd, Pdthd, Rdsnd^ Katuka-rohini and Pichu-marda 
should be used as gurgle (Kavala). The five drugs, viz., 

* 3'rikantha Datta, in his commentary on Vrinda's compilation, quotes 
this passage from the text, but does not include "somnolence" therein. 
He reads ♦•^mi^i^) H^r^Wt" in place of "^^^ f^r^T ^irewt " I 



4}^0 THE SUSHRUTA SAMHITA. [Chap. XXIl. 

Ingudi, Apdmdr^a, Danti^ Sarald and Deva-ddru 
should be pasted together and made into Vartis (sticks), 
well flavoured by the addition of perfuming drugs. 
Twice every day (once in the morning and again in the 
evening), should the patient be made to inhale the 
fumes of these burning Vartis (sticks) which have the 
property of subduing the (deranged) Kapha, and 
should be made to take the soup of Mudga boiled in 
alkaline water.* In cases of Tundikeri, Adhrusha, 
Kurma, Maimsa samghatta and Tatlu pupputa, the pre- 
ceding measures should be adopted, but the surgical 
operation should vary with the nature of the particular 
disease under treatment. 33-34. 

Treatment of Talu-paka, etc- :— 

Remedies which destroy the deranged Pitta should be 
employed in Ta^Lu-pakka (suppuration of the palate) ; 
while applications of Sneha (oil, etc.) and Sveda 
(fomentations), as well as Vi^yu-subduing measures should 
be the remedies in a case of a Tailu-oopha (swelling 
of the palate). The remedies to be employed in the 
diseases affecting the palate have been thus described 
above. Now hear me discourse on the remedial 
measures in Kantha-Roga (diseases of the throat). 
35-36. 

Treatment of Throat-diseases :- In 

a curable type of RoMni, blood letting and the 
applications of emetics, gurgles, inhalations (of medi- 
cated fumes) and errhines (Nasya) are efficacious. 
In cases of Vaitaja Rohini, blood letting should 
be first effected, and the affected part should then be 

* The alkaline water to be used in the Mudga-soup should be pre- 
pared from Yava-kshdra according to Dallana. But according to S iva* 
ddsa, alkaline water prepared from the ashes of Mushkaka, Apamarga, 
etc., should be used. 



Chap. XXII.] CHIKITSA STHANAM. 4/1 

rubbed with salts. Gurgles ^.Gandusha) of tepid 
Sneha (oil, clarified butter, etc.) should be con- 
stantly resorted to In cases of the Pittaja 
Rohini, the powdered Pattanga^ honey and sugar 
should be rubbed ^Prati-sjlrana) over (the affected part), 
and the decoctions* of Drdkshd and of Parushaka, 
should be used as gurgles (Kavala). In the Kaphaja 
type of Rohini, the affected part should be rubbed 
with Katuka and Agdra-dhuma (soot of a house — 
chimney-soot). An oil properly cooked with S'vetd 
Vidan^a, Danti and Saindhava should be employed as 
(Nasya) and employed as gurgles (Kavala). In a case 
of Riktaja Rohini, a physician shall employ the 
same measures of treatment as in the Pittaja type of 
the disease, ^y. 

Treatment of Kantha-^aluka, etc.: 

— In a case of Kantha-Saluka, it should be bled and 
treated as a case of Tundikeri, and the patient should 
be enjoined to take a single meal in the day consisting 
only of a small quantity of Yavdnna (barley-rice) with 
clarified butter. The treatment of a case of AdM- 
jihvika^ should be the same as that of Upa-jihvika. In 
a case of Eka-vrinda, blood-letting of the affected part 
should be resorted to (by the application of leeches), 
and Sodhanaf (purifying) remedies should be 
employed. The medical treatment of a case of Gilayu 
(Silatyu.-D.R.) consists of a surgical operation (on the 
seat of thi disease). Incision should be made into a 



* According to Chakra-pani, Draksha and Parushaka should be 
combinedly used in preparing the decoction. 

t The "purifying remedies" here means S'iro-virechana, fumigation, 
plasters and applications of alkali, etc,, for purifying the Doshas in the 
throat, 



472 THE SUSHRUTA SAMHITA. [Chap. XXII. 

G-ala-Vidradhi (throat-abscess Mn its suppurated stage 
and appearing at a part other than a Marma (vulner- 
able part). 38-42. 

Treatment of Sarva-sara lYlukha- 

Rog'a : — The affected part should be rubbed with 
powdered salts* in a case of Sarva-sara Mukha-roga 
(invading the entire cavity of the mouth) due to the 
aggravated Vaiya. Oil cooked with the (decoction and 
the pastes of) Vayu-subduing drugs (such as, the Bhadra- 
darvddi group, etc.) and used as errhines (Nasya) and 
gurgles (Kavala) is efficacious in this disease. After the 
application of this oil, the patient should be treated with 
the Snaihika form of fumigation (Dhuma) in the follow- 
ing manner. Juntuka leaves smeared with honey should 
be plastered with a compound of the Sdra of S'dla, 
Piydla and castor wood, the marrow of In^udi and 
Madhuka, Guggulu, Dhydmaka CGandhatrina), Mdmsi, 
Kdldnu-sdrivd^ S'ri (Lavanga), Sarja-rasa, S'dileya and 
wax pounded together and mixed with an adequate 
quantity of clarified butter or oil. It should then be 
burnt, and the patient made to inhale the fumes. This 
medicinal fumigation (Dhuma) proves remedial in the 
disease. It destroys the deranged Va(yu and Kapha, 
and proves curative in all affections of the mouth. 
In the Pittaja type of the Sarva sara Mukha-roga, all 
the morbific principles (Doshas) should be eliminated 
from the patient^s body (with emetics and purgatives), 



* Dallana and Nis'chala explain the term "^^'^^igf^*/' as the 
powders of the five officinal kinds of salt. S'iva-dasa, however, holds that 
powdered Saindhava salt only should bs used. Vrinda reads *' ^^^j^ :" 
and the commentator S'ri-kantha Datta explains it to mean either the 
powders of '^^f^qj]'', i.^., Jyotishmati or those of '%^f!j", i.e., the five 
officinal kinds qf salt.— Ed, 



Chtp. XXII.] CHIKITSA STHANAM. 473 

and all kinds of- sweet, soothing and Pitta-subduing 
drugs should be administered. Medicated gurgles 
(Gandusha), fumigation (Dhuma), Pratisdrana (rubbings) 
and purifying (S'odhana) measures as well as the 
Kapha-subduing remedies should be employed in the 
Kaphaja type of the Sarva-sara-Mukha-roga, and the 
patient should be made to take one Dharana measure 
(Twenty-four Ratis) of powdered Ati-vishd, Pdihd, 
Musta, Devaddru, Katuka and Kutaja seeds, with an 
adequate quantity of cow's urine. This medicine acts 
as a potent remedy for all the Kaphaja disorders of the 
body. Gurgles (Kavala) with milk, sugarcane juice, 
cow's urine, curd-cream, Kdnjika, oil, or clarified 
butter (Sneha) should be prescribed according to the 
nature of the aggravated Doshas involved in each case 
(of the Sarva-sara-Mukha-roga). We have described 
above the medical treatment of the affections of mouth 
which yield to medical remedies. 43-45. 

incurable Types : — Now we shall enumerate 
the different incurable types of mouth-diseases. Of 
the types of Oshtha-p^ka, those due to the vitiated 
condition of the flesh, or of blood, and those due 
to the concerted action of the aggravated Doshas 
(Sannipdta) should be deemed as incurable. Of the 
diseases peculiar to the roots of the teeth, the affections 
known as the Sdnnipjitika Danta-ns^di (Sinus in the 
gums) and the Sdnnip^tika ^aushira (Mah^-Saushira) 
should be also deemed as incurable. Of the affec- 
tions of the teeth, those known as the Syi^va-dantaka, 
Ds^lana and Bhanjana, and of the diseases which 
restrict themselves to the tongue, the one known as the 
Alstsa should be looked upon as incurable. Similarly, 
of the affections of the palate, the Arvuda should be 
deemed as incurable. Of those of the throat, the Svara- 

60 



474 THE SUSHRUTA SAMHITA. [Chap. XXII 

ghna, Valaya, Brinda, Bals^sa, Bid^riks^, Galaugha, 
Miimsa-tsina, Sataghni and Rohini should be regarded 
as beyond the pale of medicine. The nineteen kinds of 
the disease mentioned above are incurable, and the 
medical treatment of these diseases should be taken in 
hand without holding out any definite hope of 
recovery. 46—49. 

Thus ends the Twenty-second Chapter of the Chikitsita-Sthdnam in the 
I Sui'ruU Samhit^ which deals with the medical treatment of the diseases 
of the mouth. 



CHAPTER XXm. 

Now we shall discourse on the (symptoms and) 
medical treatment of swellings (Sopha). i. 

The six kinds of swelling (Sopha) appearing in the 
particular parts of the body have already been described* 
with the variations in their symptoms and the medical 
treatment to be pursued in each case. But the swelling 
known as the Sarva-sara bopha (general Anasarca) 
may be divided into five subheads. They are as 
follows, namely, the Vs^taja, Pittaja, Kapahja San- 
nip^itaja and Vishaja {t.e., the one due to the introduc- 
tion of any extraneous poison into the system). 2. 

Their causes :— The Doshas (morbific prin- 
ciples) become aggravated and give rise to swellings 
(Sopha) of the body, by such causes, as by undertaking 
a journey immediately after a meal, or by the use of 
Harita-sdkas (potherbs\ cakes and salts in inordinate 
quantities, or by the excessive use of acids by weak 
and emaciated persons, or by the use of clay, baked or 
unbaked, of lime-stones, or of the flesh of aquatic 
animals, or of those frequenting swampy places, exces- 
sive sexual intercourse, use of fares consisting of incom- 
patible articles and lastly by the joltings when riding 
on elephants, horses, camels, in vehicles, etc., or on 
persons on the part of dyspeptic patients. 3. 

Specific Symptoms :— A swelling (^opha) 

of the Va^tajsi type is vermilion or black-coloured and 
is attended with softness and a pricking pain in the • 
swelling which disappears at intervals. A swelling of 
the Pittaja type assumes a blood-red or yellow colour, 
swiftly expands and is attended with a burning and 

* See Stttca-sthJim, Cbaptei XVIL 



4^6 THE SUSHRUTA SAMHITA. tChap. XXIII. 

drawing pain (Chosha). A swelling of the Kaphaja 
type assumes a white or greyish colour, becomes hard, 
cold to the touch and glossy, is slow in its growth, and 
is attended with itching, pain, etc. A swelling of the 
Sstnnipsitika type (due to the concerted action of all the 
three Doshas of the body) exhibits all the symptoms 
which specifically belong to each of the three above- 
said types. 4-7. 

Symptoms of Vishaja-^opha : -A 

swelling (Sopha) which results from the contact or 
introduction of a (weakened) chemical poison (Gara) with 
or into the body, or from the use of polluted water, 
or by bathing in a foul and stagnant pool or tank, or by 
dusting the body with the powders of substances 
poisoned by any poisonous animal, or from the contact 
with weeds and plants, which have become poisoned 
by the urine, fcecal matter, or semen of poisonous 
animals, is called a Vishaja swelling. The swelling 
is soft, pendent and persistent, expands rapidly and 
moves gradually (from one part of the body to the 
other) and is attended with a burning sensation and 
suppuration. 8. 

Memorable Verse : —The aggravated Doshas 
of the body confined in the stomach (Amdsaya) give rise 
to a swelling in the upper part of the body. Confined 
in the intestines (Pakvasaya), they give rise to a swelling 
in the middle part of the body. If they are confined 
in the receptacle of the foeces (Malasaya), the lower part 
of the body becomes swollen. The swelling extends 
all over the body in the event of their (Doshas) being 
diffused throughout the organism. 9. 

Prognosis : — An oedematous swdling (Sopha) 
occurring in the middle part (trunk) of the body or 
extending all over it may be cured with difficulty as 



Chap. XXIIL] CHIKITSA STHANAM. 477 

well as the one which first occurs at either (the upper or 
lower) half of the body and tends to extend upward. 
A case of swelling attended with dyspnoea, thirst, 
weakness, fever, vomiting, hiccough, dysentery, colic 
(S'ula), and a want of relish for food is extremely hard 
to cure and soon proves fatal. lo-ii. 

We shall now proceed to describe their general and 
specific remedies. The use of acids, salts, milk, curd, 
treacle, lard, water, oil, clarified butter, cakes and all 
kinds of heavy (in digestion) edibles should be refrained 
from in all the types of oedema (S'opha). 12-13. 

The Special Treatment of ^opha :— 

Traivrita (Ghrita) or castor oil should be administered 
for a month or a fortnight to the patient suffering from 
the Vsitaja type of oedema (Sopha). Clarified butter 
cooked with the decoction of the drugs of the Nydgfo- 
dhddi and the Aragvadhddi groups should be respec- 
tively prescribed in the Pittaja and Kaphaja types. 
In the Sannipattaja type, the patient should be made 
to drink a potion of clarified butter cooked 
with a Pdtra* measure of the milky exudation of the 
Snuhi plant and twelve Pitra measures of fermented 
rice gruel (Kdnjika) with an adequate quantity of 
Danti as a Kalka. The remedy in regard to a swelling 
due to the action of poison (Vishaja) imbibed into the 
system will be duly described in the Kalpa Sthdnam. 14. 

The general remedies:— Now we shall 

describe the general remedies (which are applicable in 
cases of Sotha). Any of the four Ghritas ending with 
the Tilvaka Ghrita which have already been mentioned 
under the treatment of Udara would prove remedial 
in a case of S'vayathu (CEdematous Swelling). The 
use of (the officinal) urine and the applications of the 
* A Piitra measure is equal to eight seers 



4/8 THE SUSHRUTA SAMHITA. CChap. XIII 

(medicated) Vartis are likewise recommended. The 
patient should be made to take every day the 
medicine known as the Nava^yasa* through the 
medium of honey. He should be made to take a 
Dharana weight of the compound of powdered 
Vidanga, Ativishd, Kutaja-(tu\t, Bhadra-ddru, Ndgara 
and Markka in tepid water. Trikatu, Yava-kshdra 
and powdered iron should be mixed together and 
administered through the medium of the decoction 
of Triphald ; or, cow's milk and cow^s urine, in 
equal proportions should b2 taken. As an alternative, 
treacle and Haritaki mixed in equal proportions should 
be administered. Deva-ddru and S'unthi\ may be given ; 
or Guggulu* dissolved in cow^s urine or in the 
decoction of Varshdhhu. Equal parts of treacle 
and S^ringavera § may as well be prescribed ; or the 
roots of the Varshdbhu pasted with the decoction of the 
same drug and mixed .vith powdered S'unthi dissolved 
in milk should be given to the patient every day for a 
month. He should take Mudga pulse fried with the 
clarified butter prepared by cooking it with the decoc- 
tion of Trikatu and Varshdbhu. Milk boiled with 
Pippali, Pippali-roots^ Chavya^ Chitraka^ Mayura (Apd- 
mirga) and Varshdbhu, or with Sunthi and Surangi- 
roots, or with Trikatu, Eranda-roots and Sydrnd-rootSj 
or with Varshdbhu, S'unthi, Sahd and Deva-ddru 
should be given to the patient. A paste of Aldvu and 

• See Chapter XXII, para. lo, Chikitsita*sthdnam. 

t Some commentators explain that the compound of Deva*d4ru and 
S'unthi also should be taken ihrough the medium of cow's urine or the 
decoction of Varshdbhu. 

X According to Ohakradatta's reading, Deva-daru, S'unfhi and 
Guggulu should be taken together with cow's urine. 

5 The S'iringavera in this compound may be either fresh oi 
dried.— Ed. 



chap. XXIII ] CHIKITSA STHANAM. 4/9 

Vibhitaka dissolved in the washings of rice, should 
likewise be administered. 15. 

The diet of the patient should consist of cooked 
barley or wheat saturated with the unsalted soup of 
-Mudga pulse, cooked with Yava-kshdra, Pippali, 
Maricha. and S^ringavem, and prepared with only a 
small quantity of oil or clarified butter. A decoction 
of Vrikshaka, Arka, Naktatndla^ Nimba and Varshdhhu 
should be used in effusing (Parish eka) the affected part. 
It should be plastered with a compound consisting of 
Sarshapa^ Suvarchald^ Saindhava and S^drngashtd, 
pasted together. Strong purgatives, Asthdpana 
measures and applications of Sneha, Sveda and 
IJpansnia should be constantly employed according to 
the nature and instensity of the aggravated Doshas 
involved in the case. In a case of Sotha, other than 
what is the outcome or supervening symptom (Upadrava) 
of any other disease, the patient should be frequently 
bled by opening a vein of the locality. 16. 

Memorable Verse :— A patient wishing to 

get rid of an attack of Sopha (oedematous swelling) 
should refrain from taking all sorts of cakes, acid sub- 
stances, liquor, clay, salts, oil, clarified butter,* water, 
heavy and indigestible articles of food, sleep in the day 
time, the flesh of animals other than that of the animals 
of the Jdngala group and from visiting the bed of any 
woman. 17. 

Thus ends the Twenty-third Chapter in the Chikitsita Sthinam of the 
Suslruta Samhitil which deals with the medical treatment of S'opha. 

* Some read «' ^^," «•<?•. treacle in place of " ^TW," ''^m clarified 
hutter. This reading seems to be the correct one, inasmuch as it is 
supported by all other authoritative works on Ayurveda. — Ed, 



CHAPTEE XXIV. 

Now we shall discourse on the rules of hygiene and 
the prophilactic measures in general (Atlctg^at^*- 

vstdha-Prati-shedhaniya). i. 

Metrical Texts :— Now we shall describe the 
rules of conduct to be daily observed by an intelligent 
man (after leaving his bed) seeking perfect health and a 
sound body. 2. 

Tooth-brushing :— A man should leave his 
bed early in the morning and brush his teeth. The 
tooth-brush (Danta-Kishtha) should be made of a 
fresh twig of a tree or a plant grown on a commendable 
tract and it should be straight, not worm-eaten, devoid 
of any knot or at most with one knot only (on one side), 
and should be twelve fingers in length and like the 
small finger in girth. The potency and taste of the 
twig (tooth-brush) should be determined by or vary 
according to the season of the year and the preponder- 
ance of any particular Dosha in the physical tempera- 
ment of its user.* The twig of a plant possessed of any 
of the four tastes as sweet, bitter, astringent and pungent 
should be alone collected and used. Nimha is the 
best of all the bitter trees ; Khadira of the astringent 
ones ; Madhuka of the sweet ; and Karanja of the 
pungent ones. 3 

* A man of a Kaphaja temperament should use a twig of a plant 
possessed of a pungent taste (Tikta) in brushing his teeth. A man of a 
Pittaja temperament should brush his teeth with a twig possessed of a 
sweet taste (Madhura), while a man of a VsCtika temperament (nervous) 
should use that with an astringent (Kasdya) taste. This rule should be 
observed even in respect of the preponderant Doshas of the body, in a 
disease. 



Chap. XXIV.] CHIKITSA STHANAM. 481 

The teeth should be daily cleansed with (a com- 
pound consisting of) honey, powdered Tri-katu, Tri- 
vargO^, Tejovatif Saindhava and oil. Each tooth should 
be separately cleansed with the preceding cleansing paste 
applied on (the top of the twig bitten into the form of) 
a soft brush, and care should be taken not to hurt the 
gum anywise during the rubbing. This tends to 
cleanse and remove the bad smell (from the mouth) and 
the uncleanliness (of the teeth) as well as to subdue the 
Kapha (of the body). It cleanses the mouth and 
also produces a good relish for food and a cheerfulness 
ofmindf. 4. 

Cases where tooth-brushing is for- 
bidden : — Tooth-brushing is forbidden to the persons 
suffering from ^affections of the teeth, lips, throat, 
palate, ?or tongue, or from stomatitis, cough, asthma, 
hiccough and vomiting, weakness, indigestion, 
epilepsy, head-disease, thirst, fatigue, alcoholism, facial 
paralysis, ear-ache, and to persons tired with over- 
drinking. 5. 



* The term "Tri-varga" generally means Tri-katu, Tri-phala and 
Tri-mada. Dallana explains it as meaning Tri-sugandhi, i.e,^ Tvak, Eld 
and Patra.— Ed. 

+ Additional Texts :— It brings on a relish for food, imparts a 
cleanliness, lightness and sense of freedom to the teeth, tongue, lips and 
palate. It protects the mouth, throat, palate, lips and tongue from being 
affected by any disease. It arrests salivation, imparts an agreeable aroma 
to the mouth and relieves nausea and water-brush. It strengthens the 
religious inclination and gives a lightness to the organs. Hence one 
should every day use the tooih-twig, but its use is prohibited in respect 
of persons suffering from diseases of the palate, lips or tongue as well as 
from Mukha-paka (stomatitis), dyspnoea, hiccough, parchedness of the 
mouth and^ nausea. The. last two lines of the additional text, however, 
occur in the text in a slightly different form. See the next two lines of the 
text. 



482 THE SUSHRUTA SAMHITA. [Chap. XXIV. 

The use of a thin, smooth and flexible foil of gold, 
silver, or wood, ten fingers in length, is commended for 
the purpose of cleansing the tongue by scraping. It 
gives relief and removes the bad taste, foetor, swelling 
and numbness of the mouth. Sneha (oil) should be 
used as a gurgle (Gandusha) every day (after the cleansing 
of the teeth), as it makes them firm, and brings on a 
natural relish for food. 6-7. 

Eye and IVlouth -washes :— The mouth and 

the eyes of a person of sound health should be washed 
with the decoction of the barks of Kshira trees mixed 
with milk, or with that of Bhillodaka, or of Amalaka^ or 
with (a copious quantity of) cold water.* This procedure 
would soon prove efficacious in destroying such affections 
of the body, as Nilika, dryness in the mouth, pustules 
or eruptions, Vyanga and the diseases due to the 
(concerted) action of the Rakta and Pitta, and by 
such washings the face becomes lighter and the sight 
stronger. 8. 

COlIyrium :— Srotonjana, produced in the river 
Indus, is the best and purest of Collyhums. It 
alleviates the burning and itching sensations in the eyes, 
removes all local pains, secretions and impurities, 
increases the range of vision, enables the eyes to bear 



* Gayadasa interprets that the mouth should be washed with the 
decoction of Bhillodaka and the eyes with that of A'malaka, He also 
interprets that the eyes and the mouth may both, however, be washed 
with cold water. 

Perhaps Gayadasa was of opinion that the decoction of Amalaka, 
being astringent, might arrest the dilatation of the pupils due to age, 
and so help to keep the eye-sight unimpaired. Others explain that the 
mouth should be washed with the decoctions of Bhillodaka and of 
Amalaka, and the eyes with cold water. The decoctions, however, if 
used as an eye-wash, should be used in a cold state.— Ed. 



Chap. XXIV.] CHIKITSA STHANAM. 483 

the blasts of the wind and the glare of the sun and guards 
against the inroads of occular affections. Hence the 
application of collyrium (along the eye-lids) is highly 
recommended ; but its use is forbidden just after taking 
one's meal or bath (washing the head) and after the 
fatigue of vomiting, or riding, etc., nor after keeping 
late hours and also not during an attack of fever. 9-11. 

A betel-leaf prepared with cloves, camphor, nut- 
meg (Jati), lime, araca-nut, Kakkola and Katukdhva 
(Lata-kasturi), etc., should be taken (chewed after meals), 
as it tends to cleanse the mouth, impart a sweet aroma 
to it, enhance its beauty and cleanse and strengthen 
the voice, the tongue, the teeth, the jaws and the 
sense-organs. It checks excessive salivation, soothes 
the body (Hridya), and acts as a general safeguard 
against throat disease. A betel-leaf (prepared as 
before) proves wholesome after a bath, after meals, 
after anointing as well as after rising from sleep. 
A person suffering from Rakta-Pitta, Kshata-Kshina, 
thirst, or parchedness of the mouth should refrain 
from taking betel-leaf, the use of which is equally for- 
bidden in such diseases as anaemia, internal dryness 
of the organism and epilepsy. 12. 

^irobhyanga :— Anointing (Abhyanga) the 
head with oil is a good cure for the affections of the head. 
It makes the hair grow luxuriantly, and imparts thick- 
ness, softness and a dark gloss to them. It soothes and 
invigorates the head and the sense-organs and removes 
the wrinkles of the face. The medicinal oil known as 
the Chakra-Taila should be cooked with the paste 
(Kalka) and the decoction of Madhuka, Kshiras'ukid, 
Sarala, Deva-ddru and the minor Pancha-mula taken 
in equal parts (in each case). The head should be con- 
stantly anointed with this cooling oil. 13-14. 



484 THE SUSHRUTA SAMHITA. [Chap. XXlV. 

Combing the hair improves its growth, removes 
dandriff and dirt, and destroys the parasites of the scalp. 
Pouring oil (Karna-purana) into the cavities of the ears 
is highly efficacious in pains of the jaws (Hanu'^ and of 
the Manya, and acts as a good cure for head -ache and 
ear-ache. Anointing (Abhyanga) the body (with oil, 
etc ) imparts a glossy softness to the skin, guards 
against the aggravation of the Vayu and the Kapha, 
improves the colour and strength and gives a tone to the 
root-principles (Dhdtus) of the body. * I5-I7- 

Parishcka :— Affusing the body (Parisheka) 
removes the sense of fatigue, and brings about the 
adhesion of broken joints. It alleviates the pain which 
usually attends burns, scalds, bruises and lacerations, and 
subdues the actions of the deranged Viyu. Sneha (oil) 
affused on the human organism imparts a tone and vigour 
to its root-principles (Dhdtus), in the same manner as 
water furnishes the roots of a tree or a plant with the 
necessary nutritive elements, and fosters its growth^ 
when poured into the soil where it grows. The use of 
Sneha (oil, etc.) at a bath causes the Sneha to penetrate 
into the system through the mouths of the veins (Siras) 
and the ducts (Dhamanis) of the body, as also through 



* Rubbed on the body and allowed to stand or kept unwiped, the 
Sneha (oil) reaches down the skin, through the hair-follicles in the course 
of time necessary to utter four hundred Matras. It reaches the principle 
of blood in the course of that necessary to utter five hundred Matras, 
and to the principle of flesh in the course of that necessary to utter six 
hundred Matrds. It penetrates further to the principle of fat in the 
course of that necessary to utter seven hundred Matrds, and to the 
principle of bone in the course of that necessary to utter eight hundred 
Mdtrds, and lastly to the principle of marrow in the course of that 
necessary to utter nine hundred Miitis. It successively cures the diseases 
respectively located in those principles. — Dallana. 



Chap. XXIV. CHIKITSA STHANAM. 485 

the roots of the hair, and thus soothes and invigorates 
the body with its own essence. 18 — 20. 

Under the circumstances, affusions and anointments 
of the body with oil or clarified butter should be pre- 
scribed by an intelligent person with due regard to one's 
habit, congeniality and temperament and to the climate 
and the season of the year as well as to the preponder- 
ance of the deranged Dosha or Doshas in one's physical 
constitution. 21. 

Prohibitions of anointments, etc.:— 

Anointments of the body simply with (unmedicated) 
Sneha are strictly forbidden in cases of undigested (Ama) 
Doshas (as long as the aggravated Doshas of the body 
continue in an unassimilated or undigested state and 
in their full virulence and intensity). Anointment should 
not be resorted to in cases of acute fever and indiges- 
tion, nor after the exhibition of emetics and purgatives, 
nor after an application of a Nirudha-Vasti. Anoint- 
ment in the first two cases (acute fever and indigestion) 
serves to make the diseases curable with difficulty and 
even incurable, while that made on the same day after 
the application of purgatives, emetics, or a Nirudha- 
Vasti, tends to impair the digestive capacity, etc. Anoint- 
ment is similarly prohibited in diseases due to Samtar- 
pana (repletion, etc). 22 — 24. 

Physical Exercise :-- What is (popularly) 

known as physical exercise is (nothing but) a sense 
of weariness from bodily labour, and it should be 
taken every day. After taking physical exercise, the 
whole body should be shampooed, until it gives rise 
to a comfortable sensation in the limbs. It makes 
the body stout and strong, helps the symmetrical 
growth of the limbs and muscles, improves the com- 
plexion and the digestive powers, prevents laziness and 



436 THE SUSMRUTA SAMHITA. CCJ^ap. XXlV. 

makes the body light and glossy, firm and compact. 
The power of enduring fatigue and weariness and 
the variations of temperature, thirst, etc., are the 
virtues which are invariably found to follow in its 
train. It leads to an undiseased existence and is the 
best means of reducing corpulency. The enemies of 
a man habituated to regular physical exercises, dare 
not molest him through fear (for his strength — D. R.). 
Imbecility and senile decay never approach him, and 
the muscles of his body become firm and steady. 
Diseases fly from the presence of a person, habituated* to 
regular physical exercise and (subsequent) shampooing, 
just as small beasts do on seeing a lion. It makes an 
aged and deformed man (youn^2j and) good-looking. 
Food consisting of articles incompatible in their 
potency, and indigested and decomposed food are easily 
digested in a man who takes regular physical exercise 
(and cannot produce any bad effects Regular physical 
exercise is (particularly) beneficial to a strong man 
accustomed to the use of emollient food (abounding in 
proteid matter), in all seasons of the year ; but in 
the winter and the spring, it is highly (indispensably) 
necessary for him. A man seeking his own good should 
take physical exercise every day only to the half extent 
of his capacity (Valardha), as otherwise it may prove 
fatal. That amount of exercise which makes the Prdna- 
Vayu come out through the mouthf {i e., as soon as 

* Dallana's reading here evidently is "o?n?ITTf^^1T^^" >n P'^^e ol 
"o^T^nW^^TT^^" I "^^'^ would mean "of one taking so much exercise 
as produces sweat." 

t According to several authorities, the appearance of perspiration 
on the nose, the axilla, the forehead and in the joints of the hands 
and the legs and dryness of the mouth are the symptoms which 
indicate that one has taken Valstrdha physical exercise (i.e., to the 
half extent of his capacity).— Dallana. 



Chap. XXIV.] CHIKITSA STHANAM. 487 

hard-breathing would set in), is known as the Valairdha 
exercise. One's own age, strength, physique and food 
as well as the season of the year and the physical 
nature of the country are the factors which should be 
considered before one began to take physical exercise, 
as otherwise it might bring on some disease 25. 

Consumption, haemorrhage (Rakta-pitta), thirst 
phthisis, aversion to food, vomiting, illusiveness, weari- 
ness, fever, cough and asthma are the diseases, which are 
likely to originate from excessive physical exercise, 
and is, therefore, forbidden after a meal and the fatigues 
of sexual intercourse, in a fit of vertigo and in respect of 
persons suffering from haemorrhage, phthisis, cachexia, 
cough, asthma and ulcer. 26-27. 

The deranged Vayu of the body is restored to its 
normal condition by the help of Udvartana (massage). 
It reduces the fat and the aggravated Kapha of the 
system, smoothes and cleanses the skin and imparts a 
firmness to the limbs. 28 

Utssbdana (rubbing) and Udgharshana* (friction) 
tend to dilate the orifice of the (superficial) ducts and 
increa.se the temperature of the skin. Utsddana 
specifically improves the complexion of females and 
gives a lovely appearance, cleanliness, beauty and 
suppleness to the female form. Udgharshana (friction) 
pacifies the bodily Vdyu, cures itches, rashes and 
eruptions (Kotha). Phenaka t imparts lightness and 
steadiness to the thighs, cures itches, eruptions, Vdta- 
stambha and excretal diseases. Friction of the body 
with brickbat powders excites the heat of skin, brings 

* Utsadana and Udgharshana are the two kinds of rubbing the body 
with medicinal powders with and without a Sneha respectively. 

t Phenaka is a kind of friptJPn of the body with small wooden 
rollers. 



488 THE SUSHRUTA SAMHITA. .[Chap. XXIV. 

on the dilation of the orifices of the bodily ducts^ and 
cures itches and Kotha. 29-32. 

Bathing' : — Bathing removes somnolence, (in- 
ordinate) bodily heat and a sense of fatigue. It allays 
thirst and checks itching and perspiration, brings on a 
fresh relish for food, removes all bodily impurities, clears 
the sense-organs, gladdens the mind, purifies the blood, 
increases the appetising power, destroys drowsiness and 
sin, and increases semen. The sight of a man is 
invigorated by applying cold water to the head at the 
time of bathing, while the pouring of warm water on 
the head tends to injure the eye-sight. In cases 
of an aggravation of the deranged YAyu and Kapha, 
the head may be washed with warm water, as a 
medicine, after a careful consideration of the intensity 
of the disease. 33-35 

Prohibition of Bathing :— Bathing in 

extremely cold water in winter tends to enrage the 
bodily Vayu and the Kapha, while bathing in hot water 
in summer agitates the blood and the Pitta. Bathing 
is not beneficial in fever, diarrhoea, ear-ache, tym- 
panites, Adhmana, aversion to food and indigestion, and 
in the disorders or diseases due to the actions of the 
deranged Vayu. It should not also be taken just after a 
meal. 36-38, 

Anulepana :— Anointing (Anulepana) the body 
(with scented pastes) removes a sense of fatigue and 
foetor and perspiration. It produces a sense of pleasure 
and improves the Ojas, the strength and the complexion 
of the body^ enhances the beauty and glow of the frame 
and gives it a lovely appearance. Anulepana is forbidden 
in those cases in which bathing is prohibited. 39- 

The wearing of gems, flowers and clean clothes is 
beneficial in a variety of ways, as it acts as a goo4 



Chap. XXIV.] cniKITSA STHANAM. 489 

prophylactic against the influences of monsters and 
malignant spirits, enhances the Ojas and the beauty of 
the body and keeps the mind in a cheerful mood and 
proves highly auspicious. 40. 

Alepa.: — Besmearing (Alepa^ the face (with scented 
pastes, etc.) imparts steadiness to the eyes, brings on a 
broad and graceful contour of the cheeks and mcuth, 
produces their healthful glow like that of a lotus flower 
and prevents its disfigurement by pimples, moles and 
such like growths and eruptions (Vyanga). The use of 
collyrium (Anjana) furthers the growth of large and 
beautiful eye lashes, cleanses the eyes by removing 
the unhealthy secretions, makes the eyes more wide 
and graceful and also imparts a brilliant lustre to the 
pupils. 41-42. 

Devotion to the gods and Brahmanas and hospi- 
tality towards guests fAtithi) add to one's good 
name, piety, wealth, progeny and duration of life. 
Food (Ahara) nourishes and gladdens the heart and 
directly contributes to one's bodily strength. It 
improves the memory, appetising power, energy and 
the natural strength of the mind (Tejas\ and increases 
the Ojas and the duration of one's life. 43-44. 

Washing the feet increases the semen (Vrishya), re- 
moves the sense of fatigue, gladdens the heart, makes the 
soles free from all adhering dirt and local diseases, acts 
as a prophylactic against evil spirits (Rakshoghna) and 
clears up* the vision. Anointing (Abhyanga) the 
feet (with oil, etc) brings on sleep. It is refreshing 
and invigorating to the body and the sight, removes all 

• Dallana explains that washing the feet keeps the nerve (Nadi) 
joining the soles with the eyes cool and thus helps to clear up the vision. 
There is a custom of frequently washing the feet amongst the Hindus 
rpost probscbly on this account. — Ed. 

62 



490 THE SUSHRUTA SAMHITA. [Chap. XXIV. 

drowsiness and sense of fatigue and softens the skin of 
the soles of the feet. 45-46. 

The use of shoes is efficacious in curing the diseases 
of the feet and is conducive to pleasure and verile 
potency. It acts as a prophylactic against the influences 
of evil spirits, makes walking easy and pleasant, and 
improves the Ojas in the body. Walking without shoes 
is perilous to life and health, and is attended with 
the danger of impaired vision. 47-48. 

The shaving of hair and the paring of nails lead to 
the expiation of one's sins, make a man cheerful, tend 
to appease his fate, increase his energy and impart 
a lightness to the frame. The putting on of armour 
(Va'nava(ra) improves one's strength, energy and com- 
plexion and gives a lustre to the body. The wearing of 
a turban (Ushnisha'^ acts as a protection against wind, 
dust, sun and light, helps the luxurious growth of hair 
and tends to improve the purity of the mind. 49-5 r. 

The use of an umbrella is a protection against 
rain, wind, dust, dew and sun It improves one's 
energy, Ojas, eye-sight and complexion, and is an 
auspicious thing in itself. The use of a stick (Danda) 
dispels the fear of dogs, snakes, beasts of prey, 1 tigers, 
etc) and horned animals. It considerably alleviates 
the toil of a journey, lessens the probability of making 
a false step and is specially commended to the weak 
and imbecile. It increases one's energy, strength and 
patience, makes the mind firm and bold, acts as a proper 
support and mnkes one fearless. 52 53. 

Sitting idle (Asyat) gives pleasure. It improves the 
glow of one's complexion, increases the Kapha and corpu- 
lency and makes the body delicate, while an active pedes- 
trian habit (A.dhva) is detrimental to the complexion. 
It reduces the fat and Kapha of the body, and removes 



dhap. XXlV.j CHIKITSA STHAKAM. 491 

the delicateness of the frame. Contrary results (to those 
produced by sitting idle) are produced by excessive 
walking which further brings on weakness and emacia- 
tion of the body. A gentle walk or stroll, which is not 
very fatiguing to the body, tends, on the contrary, to 
improve his memory, strength, digestive capacity 
(Agni) and the functions of the sense-organs. It 
increases also the duration of life. 54 57. 

Lying down in an easy posture on a soft bed removes 
the sense of fatigue, pacifies or soothes the bodily 
V^yu, brings on sleep and lost recollections to the 
mind, is spermatopoetic and is conducive to the 
growth of the body ; while lying down in a contrary 
manner is attended with contrary results. Fanning 
with Chowiies (Vatla-vyajana) is refreshing and keeps 
off flies and mosquitoes ; while fanning (with ordinary 
fans) arrests p.^rsp'ration, removes the sense of fatigue 
and fainting fits, and alleviates the burning, scorching 
and parched sensations. Shampooing (Samvathana) is 
pleasant, refreshing, soporific, and spermatopoetic 
(Vrishya\ It destroys the bodily Vayu and Kapha, 
removes the sense of fatigue and is soothing to the 
blood, skin and the musc!es. 58-60. 

A strong wind (Pravatta) is parchifying in its effect 
and injurious to the complexion. It destroys the burning 
sensation (if any) in the body, allays thirst, removes 
fainting fits and stops perspiration, but (at the same 
time) produces numbness of the body and destroys the 
digestive powers ; whereas the contrary results are pro- 
duced by a gentle wind. The gentle breeze of summer 
and of autumn should be breathed (as it is attended 
with beneficial results to the health). A seeker 
after health and a long life should reside in a chamber, 
not exposed to strong blasts of wind (Niva'ta). An 



492 THE SUSHRUTA SAMHITA. [Chap. XXIV. 

undue exposure to the sun (Atapa) aggravates the Pitta, 
but increases the power of digestion. It agitates the blood 
and begets thirst, perspiration, faintness (sun-stroke), 
vertigo and a burning sensation in the body attended 
with a discolouring of the complexion, etc. ; whereas 
the contrary results are produced by a (cool) shade 
(Chhakya^). A basking in the glare of fire (Agni) remedies 
the (wrong) coursing of the Vayu and Kapha, removes 
cold and shivering, digests the slimy secretions in the 
channels ; but aggravates the blood and Pitta. A good 
sleep (Nidra.) enjoyed at the proper time (and for 
the proper period) tends to improve the growth, strength, 
vigour and complexion of the body. It increases 
the power of digestion, removes drowsiness, and 
restores the natural equilibrium among the different 
fundamental principles (Dhatus) of the organism. 6l 65. 

General rules of conduct :— The first 

rule is that one should keep his nails and hair short, 
always put on clean and white clothes, wear a light turban 
and a pair of shoes and carry an umbrella and a stick in 
his hand. One should discourse, when necessary, with 
another in a sweet and gentle voice and his speech 
should be laconic and pleasing. He should first accost 
his elders and acquaintances in cases of meeting before 
they speak. He should be kind and compassion- 
ate to all creatures, and be approved of by his elders 
and superiors. He should be in full possession of re- 
sources and in an undisturbed state of the mind. One 
should not stir out at night nor walk about in the grounds 
of public executions, undulated places, dens and rocks.* 
He should not go (at night) to where roads cross nor 
to places covered with heaps of husks, ashes, bones, 

* The text has Indra-kila which means a hilly country inhabited 
by barbarous people. 



Chap. XXIV.] ClilKlTSA STHANAM. 493 

hair, stones, baked earth. and charcoal, nor to places 
commonly considered as unholy. 66. 

Men should never deride a king, nor use harsh and 
impolite words to, nor act meanly and treacherously 
towards him. One should not speak ill of the king, 
the gods, the Brahmanas and the Pitris (departed 
Manes), and he should never use harsh and slanderous 
words. He should not tell a lie nor associate with 
king-haters nor with the insane, degraded, mean and 
narrow-hearted persons. 6y. 

Climbing up trees, mountains, ant-hills and undula- 
ting grounds, etc, and going up to a waterfall as well as 
riding on a wild and unbroken horse or elephant are 
strictly prohibited. One should not descend into an 
unknown tank, den as well as into the sea or into a river 
at flood times. Old haunted and deserted houses, cre- 
mation grounds and solitary forests should be strictly 
shunned. One should not come into actual contact 
with fire, wild beasts, snakes and venomous insects. 
The site infested with wild beasts, snakes, venomous 
insects, lizards and horned animals as well as where 
virulent epidemics would be raging should be avoided, 
nor should the sites of actual affrays and battles be 
resorted to, nor the scene of a violent conflagration of 
fire. 68. 

Passing between two rows of fire, between cows, 
elders, Brahmanas, moving cradles and a married couple 
is forbidden. One should not (unnecessarily) follow a 
corpse. Even the shadow of a fallen, degraded and sick 
person as well as of a cow, Brahmana, divine image, 
banner or of a Chaitya (tree growing on a cremation 
ground) should not be trodden upon. One should 
not gaze at the rising or the setting sun. One 
should not report to another the fact of a mijch 



494 THE SUSHRUTA SAMHITA. [Chap. XXlV. 

COW sucking her own calf, nor of her traversing or freely 
grazing in another's field nor the fact of witnessing a 
rainbow or a meteor fall. One should not blow up a fire 
with one's breath, nor hit the ground or water with 
one's hands and feet. Cg. 

A man should never repress any natural urging of 
his body, nor should he pass water or evacuate excre- 
ments in an open or public place, within the confines of 
a town or village, close to a cremation ground or any 
place of worship, at the crossing of roads, in reservoirs 
of water or on the high road nor should he do so facing 
a fire, in the presence of his superiors, cows, the sun and 
the moon nor facing against the wind. 70. 

Scratching (unnecessarily) the ground with one's 
nails, etc., should not be done, and one should not yawn 
nor sneeze, nor raise any eructations nor breathe hard in 
an assembly (of gentlemen) without previously covering 
his face. Sitting in an unseemly raised-up position on a 
couch as well as with extended feet in front of one's 
superiors should be renounced, yi. 

The hair, nostrils, ear holes, teeth or any channel of 
the body should not be fingered. The hair, face, finger- 
nails, clothes and the body should not bs shaken. Never 
keep time with music by beating the body or the 
cheeks with the hands or by striking the finger nails 
against each other. Never (wantonly) strike or break or 
cleave a piece of wood or stone or weed, etc. 72. 

Never expose yourself to the rays of the sun, or to 
the gusts of wind blowing in your face. Basking before a 
fire immediately after a meal or sitting on one's legs on 
a narrow wooden stool should not be indulged in. Never 
hold the neck in a con trar}^ (contorted) posture. Neither 
do nor eat anything by keeping the body in a contrary 
posture. Never look steadfastly towards any object and 



ChapXXIV.] CHIKITSA STHANAM. 495 

particularly towards the sun or any luminous body* or 
towards any extremely attenuated, revolving or moving 
object. Never carry a load on the head. Sleeping, wak- 
ing, sitting, lying down, walking, jumping, running fast, 
plunging in water, swimming, riding on a horse or in 
a vehicle, talking, laughing, sexual iiitercourse and 
taking (any other) physical exercise though accus- 
tomed and recommended should not be inordinately 
indulged in. Ji. 

A bad habit should be gradually discontinued and 
a good one even when (beneficial to health) should 
similarly be gradually inculcated by a quarter only and 
not all at once. 74. 

It is improper to lie down with one's head downward. 
One should not drink water from a broken vessel nor 
with the help of blended palms. Food, which is 
wholesome and approved of by one's physician and 
which abounds in arricles of sweet and emollient pro- 
pertiesf shou'd be taken at the proper (and regular) 
time (every day; in a moderate quantity. It is forbidden 
to take any food in the house of a trader (?>., of a 
(hotel keeper) or a courtesan, nor in the house of a 
wily, degenerate or inimical person, nor at a village- 
assembly. The refuse of another's dishes, as well as 
articles of fo„d infested with flies, insects, etc.^ or 
po sessed of an objectionable colour, taste, smell, touch or 

* Some explain "Jyotish" as a blaz. of fire and others explain it as 
stars. 

t The fram^rs of the Ayurveda were aware of the fact that the human 
system is incapable of directly assimilating starchy substances without 
converting them into sugar. This has been emphasised in the Sutra- 
S hana, where Sus'ruta insists that a food stuff, in order to be worthy 
of the epithet, must be Madhura (z ^ , of sweet flavour) and contain 
a large qnantity of proteid matter si;ch as is found in milk, butter. 
meat, etc— ^d. 



495 THE SUSHRUTA SAMHITA [Chap. XXIV. 

sound or those which producelan unpleasant impression 
in the mind, or food of like nature as well as those 
served (handled) by many persons should not be partaken 
of (in spite of repeated requests in '.that behalf). It is 
not advisable to sit down to a meal without washing 
one's hands and feet. One should never take anything 
by repressing a natural urging for stool and urine, nor 
sit down to a meal just at the break or the close of day, 
nor in an unprotected situation {i.e. without any shade, 
or without something to sit upon). One should not take 
his meal after the expiry of the (daily) appointed time 
nor in an insufficient or inordinate quantity, nor partake 
of food whose Sneha (oleaginous substance) has been 
removed. 75. 

Metrical Text :— It is forbidden to see one's 
image reflected in water, nor is it advisable to plunge 
naked into water. Curd should never be taken at 
night, nor should it be taken (at all) without sugar * or 
clarified butter, nor without saturating it with Mudga- 
soup or the admixture of honey, nor without (the 
expressed juice of) the A'malaka, nor with any hot 
substance f or article, as otherwise it may bring on 
Kushtha (cutaneous affections), erysipelas, etc. 76-77. 

Exercise, addiction to wine, gambling and music are 
bad. One should not bear witness to any fact (before a 



* Dallana adds that curd should not be taken without an addition of 
water and salt as well. This is also the practice in general. 

t All the existing editions of the Sus'ruta Samhila read *'«f|'^; " (i e., 
curd should not be taken with any "hot" substance). Here it should be 
noted that the term "hot" may also include the substances which are heat« 
making in their potency. Here, however, the reading seems to be in- 
correct. The lines are found verbatim in the work of Charaka, where he 
reads "^^j" ^'•<?'» hot curd should not be taken, since it produces, as he 
himself tells us later on, an aggravation of the blood and the Pitta.— Ed, 



Chap. XXIV.J CHIKITSA STHANAM. 497 

law court), nor stand surety for anj^ body. One should 
not use the shoe, umbrella, garland (of flowers), orna- 
ments or ragged clothes previously used by anothjer. 
Never defile a Brdhmana, or a fire, or a cow by 
touching them before washing (your hands and mouth) 
after eating. 78. 

IVIemorable Verses :— The general rules of 
(good) conduct are described above. Health, wealth 
and longevity never fall to the lot of those who do not 
follow these rules of conduct. A wise man should take 
food of such tastes (Rasa) in any particular season 
of the year as is antidotal to the bodily Dosha which 
is naturally aggravated in that season. 79-80. 

Rules of drinking water, etc. :— Water 

should not betaken during the rainy season and only in 
moderate quantities in autumn. Water may be spar- 
ingly taken during the first four months of the rainy 
season ;^if found to be indispensably necessary). Hot 
water should be taken in winter and spring (Vasanta), 
but cold water to one's fill in summer. Sidhu and 
Arishta should be taken in winter and spring. 
Water boiled and subsequently cooled should be drunk 
in summer and meat-juice in Prdvrit. Yusha (Mudga- 
soup, etc.,) should be taken in the rainy season and 
cold water after the expiry of the rains. These rules 
should be observed only by persons in sound health, 
whereas the rules regarding persons suffering from 
any disease should be regulated by the prescription, of 
any diet according to the particular Doshas involved 
in each case. 81-82. 

Any Sneha (such as oil or clarified butter) satura- 
ted with powdered Saindhava salt and Pippali should be 
regularly taken for the purpose of imp;:ovittg the 
digestive capacity. The natural urging of the body 

63 



498 THE SUSHRUTA SAMHITA. [Chap. XXIV 

should never be repressed (as a repressed physical pro- 
pulsion is sure to usher in a physical distemper). A 
Sneha (oleaginous substance) should be freely and largely 
used during the Pr^vrit and the spring seasons as well as 
in antumn (Sarat)as such a proceeding would act as a 
good appetising measure and a cure for diseases. Eme- 
tics, purgatives and applications of Vastis are respec- 
tively beneficial in diseases due to the actions of the de- 
ranged Kapha, Pitta andVayu, whereas a regular course 
of physical exercise tends (equally) to curb an ag- 
gravation of all the three preceding Doshas of the body, 
so much so that their aggravation can never be detected 
in persons in the habit of taking it regularly 
every day, though otherwise addicted to an incompatible 
diet, etc. 83-86. 

The attention should not be diverted to any other 
subject at the time of urination, defecation, sexual inter- 
course, taking of food, as well as at the time of taking 
emetics and purgatives, etc. It is not wise to anticipate 
and indulge in the gloomy thoughts of a future and 
probable invasion of a disease, and to suffer any physical 
privation on that account. 87-88. 

All sexual excesses should be studiously abstained 
inasmuch as they are sure to produce Sula (colic), 
cough, asthma, fever, emaciation, phthisis, jaundice, 
epilepsy, convulsions, etc. A person, who is moder- 
ate in sexual intercourse, lives a long life, becomes 
good-looking, healthy, strong and firm in his nerves and 
muscles, and becomes capable of averting (untimely) 
decay. One may visit his wife (lit. a woman) on each 
fourth night in all the seasons of the year except in 
summer when he may see her once a fortnight. 89- A. 

Women unfit to visit :— A woman in 

her menses, not amorously disposed, uncleanly in -her 



dhap. XXIV.] CHIKITSA STHANAM. 409 

habits, not sufficiently endeared and endearing and 
belonging to a higher social order* older than one's self,, 
affected with any disease, wanting in any limbs, inimi- 
cally disposed to one's self, in her period of gestation, 
suffering from any uterine disorder, belonging 
to his own blood (Gotra), or leading the life of 
an anchorite, or who is his preceptor's wife, should 
not be gone unto by a man (seeking health and 
longevity). A woman should not be gone unto in 
the Sandhyds (morning and evening), as well as on the 
Parva daysf (prescribed in the S'^stras), early in the 
morning, at mid-day, or in the dead of night. Going unto 
a woman at an infamous, unwholesome, or exposed place 
is similarly forbidden. Sexual intercourse by a man who 
is hungry, or thirsty, or who may be suffering from any 
disease, or may be angry, or in a cheerless spirit, is strict- 
ly forbidden. A man should not go unto a woman by 
repressing a natural urging for Vdta (flatus), stool or 
urine, or if he is in a weak state of health, (as it would 
be highly injurious to his health). Incest with lower 
animals, unnatural sexual intercourse, obstruction of 
semen in its passage, as well as sexual intercourse with 
a woman having any vaginal disease are strictly for- 
bidden even in respect of a strong person. 89-B. 

It is highly injurious for a man to indulge excessive- 
ly in sexual intercourse, or to enjoy it while standing, 
or while lying on his back, or to shake his head at the 
time ; these should not be indulged in by an intelligent 

* The text has "Varna-Vriddha" which literally means superior 
to the man in respect of Varna or the magnetic vibrations of the body, 
which are determined by one's birth in a certain family. It means 
several castes of the Hindus.— Ed. 

t The Parva days are the 8th, the 14th and 15th days of either fort- 
nights and the last days of the solar months. — Ed. 



500 THE SUSHktJTA SAMMITA. tChap. XXlV, 

and judicious person even (occasionally for pleasure's 
sake. 89-C. 

Evil effects of the foregoing abuses : 

— Visiting a woman in her menses results in the loss of 
sight, longevity and vital power, and should be accord- 
ingly considered as a sinful act. The duration of a 
man's life is diminished by going unto a woman, older 
in age or higher in social status (Varna), or unto the 
wife of his preceptor or superior, in the morning or 
the evening, or on the Parva days (the interdicted days), 
or'unto a woman belonging to the same blood as he. A 
visit to a woman big with child is extremely painful 
and injurious to the foetus confined in the womb. A visit 
to a diseased woman results in the loss of the man's 
vital power. A going unto a deformed, uncleanly, 
spiteful, non amorous, or sterile woman, or at an 
unclean, infamous, or exposed place is detrimental to 
the semen and intellect of the visitor 89-D. 

Similarly, sexual intercourse enjoyed by a man at 
noon time, or by one who is in an enfeebled, thirsty, or 
hungry state of the body, in a standing up posture, or 
in a cheerless mood, brings on an excessive loss of semen 
and aggravation of the bodily Vdyu. Phthisis due to the 
loss of semen is the result of over-intemperance in sexual 
matters. Pain, enlargement of the spleen, epilepsy 
and even death may follow from sexual gratifica- 
tions in a diseased state of health. The Vdyu and 
the Pitta become aggravated by the sexual inter- 
course enjoyed early in the morning or at midnight. 
An incest with lower animals, unnatural sexual inter- 
course, or that with a woman having a diseased vagina 
is attended with an excessive loss of semen and an 
aggravation of the bodily Vdyu, and is the cause of Upa- 
damsa (syphilitic virus). An act of coition enjoyed by 



Chap. XXIV.] CHIKITSA STHANAM. 5OI 

holding the woman on one's bosom or by repressing the 
natural urgings towards urination or defecation, as well 
as a repressing of seminal discharge would help 
the early formation of seminal concretions (in the 
bladder). 89-E. 

Hence these (injurious and harmful) practices should 
be shunned by a man for his welfare in this life as well 
as for that in the next. On the contrary, repression of a 
natural and (legitimate) sexual desire, from a sense of 
unwise delicacy or shame, is a physical sin.* Hence a 
healthy and passionate man possessed of the necessary 
fecundating element, under the course of a proper Vdji- 
karana (aphrodisiac) remedy, should cheerfully go 
unto and duly enjoy the pleasures of company with 
a girl, beautiful in looks, tender in years, modest, virtu- 
ous, equally passionate, cheerful, kindred to him both in 
physical and mental temperaments, and well-decked 
with ornaments. Fatigue after coition should be re- 
moved by the enjoyment of a bath f, a cool breeze, or a 



* It should be always borne in mind that God has implanted 
this desire in the mind of man and provided him with the necessary 
organic appendages only for the propagation of his species and not for 
the gratification of any diseased or morbid sexual propensity which is 
found nowhere else in Nature save and except in debauched human 
subjects and which lowers them even below the level of brutes. Hence 
love should be the essence of the bond which binds a couple and 
converts them into a kind of human centaur, the man and the wife, and 
union sexually considered, should be effected only under the promptings 
of that sacred instinct in Nature which makes the lilies blow and causes 
the pollens to unite their fecundating principles with one another and 
which a healthy unsophisticated human heart can instinctively read as 
the seed time of youthful exuberance. 

t A bath is recommended for a man of strong virile power, in case of 
sexufil intercourse in the day time or it may be possible to take a bath 
early in summer nights.— Dallana. 



502 THE SUSHRUTA SAMHITA. [Chap. XXIV. 

sound sleep. Food or milk, saturated with sugar, and 
meat-juice, prove very refreshing after the act. 89. 

Thus ends the Twenty-fourth Chapter in the Chikitsita Sthdnam of the 
Sus'ruta Samhitd which deals with the rules of Hygiene and the prophy- 
lactic measures in general. 



CHAPTER XXV. 

Now we shall discourse on the medical treatment of 
a variety of diseases (Misraka-Chikitsita). i. 

It has been stated before that blood-letting is the 
remedy in diseases of the Paili (ear-lobes). Now hear 
me describe in detail the treatment of those affections 
which are confined to the lobes of the ears. They are 
five in number and are called the Paripota, Utpakta^ 
Unmantha. Duhkha-Vardhana and the Parilehi. 2-3. 

Causes and Symptoms : -if the lobe of 

an ear be suddenly pulled and kept in that position for a 
long time, a numbed and painful swelling of a blackish 
red colour is produced on the lobe, owing to its soft 
and delicate nature. This is found to spontaneously 
burst or crack, and is called the Paripota, which 
should be ascribed to the action of the deranged Va(yu 
(of the system). 4- 

A painful swelling attended with a burning sensation 
and suppuration, appearing in the lobe of the ear, 
owing to the friction and movements of a heavy orna- 
ment worn in the lobe, is originated from the vitiated 
condition of the blood and the Pitta. Its colour is 
either brown or red and is called the Utpsita. 5. 

Pulling the ear-lobes down by f >rce tends to enrage 
the V^yu (of the localities) which in union with (the 
deranged) Kapha gives rise to a painful swelling in those 
regions, attended with itching and tinged with the 
specific colours* and symptoms of the Doshas 
involved. The disease is called the Unmantha, and is 

* Madhava in his compilation reads *' ^djH^<<* l H " ^^^^^ ^^^ 
swelling is attended with a numbness and no pain) in place of "f^^ iy^^^^j ," 
Vdgbhata also supports this. — Ed, 



504 THE SUSHRUTA SAMHITA. Chap. XXV. 

originated through the concerted action of the deranged 
Vaiyu and the Kapha. 6. 

A swelling in an ear-lobe attended with pain, 
burning and itching sensations owing to its being (pulled 
down and) lengthened, when found to suppurate (in the 
end) is called the Duhkha-vardhana ; it* restricts itself 
only to the skin (of the affected part . 7. 

Small exuding pustules resembling mustard-seeds 
(in size) and attended with pain, burning and itch- 
ing sensations, appear in the lobes of the ears owing to 
the action of the vitiated blood, or the deranged Kstpha, 
or to the presence of parasites (in those localities). 
The disease soon spreads itself (and assumes an erysi- 
pelatious character). It is called the Parilehi from the 
fact of its eating away the affected lobe with the entire 
helix. 8. 

General Treatment :— These dreadful dis- 
eases (which invade the lobes of the ears) are highly 
dangerous and tend to destroy and eat away the affected 
appendages, if not properly attended to at the outset and 
specially when the patient is addicted to unwholesome 
food and drink and to an injudicious conduct of life. 
Hence a physician should speedily remedy these 
complaints with applications of medicated Sneha, 
Sveda, etc., ointments, washes, plasters, poultices and 
blood-Ietting.t This is the general treatment of those 
diseases. 9. 

* Madhava adds "an unsuccessful perforation (in the ear-lobe)" 
to be an additional cause of this disease. He also reads **f^-^"^ 
i.e., **due to the concerted action of the three Doshas" in place of 
"cef^n^j^". Madhava has Vagbhata's support in this.— Ed. 

t In cases of the predominance of the VsCyu, anointment, Anuvd- 
sana and poultices should be resorted to. In cases of Pitta-predominance, 
• purgatives should be applied. Emetics should be applied in cases of 
Kapha-predominance and lastly blood-letting, purgativ^^ and washes, 



Chap. XXV.] CHIKITSA STHANAM. 50 5 

Specific Treatment :— Now we shall de- 
scribe the medical remedies which should be specially 
used in anointing (the afifected parts in these diseases). 
Drugs, such as Khara-Manjari, Yashti-madhu, Sain- 
dhava, Deva-ddru, As'va-gandhd and the seeds ol Mulaka 
and of Avalguja should be pasted together and cooked 
with a compound of milk, oil, clarified butter, lard, 
marrow and wax. This preparation should be applied 
lukewarm to the affected lobe in a case of the Pari- 
potaka type. lo-ir. 

Manjishthd, Sesamum, Yashti-madhu, Sdrivd, 
Utpala^ Padma-kdshtha, Rodhra, Kadamba and the 
tender leaves of the Vald^ Jambu and Amra (mango) 
should be cooked together with (an adequate quantity of) 
oil and Dhanyamla (Kdnjika). This oil proves curative 
in a case of Utpaita. 12. 

Similarly (a medicated) oil cooked with Tdla patri, 
As'va-gandhd, Arka, Vdkuchi-SQQils, Saindhava^ Sarald^ 
Ldngaliy lard of a Karkata (crab) and of a Godhd. (a 
kind of lizard), proves beneficial in cases of Unmantha. 
The affected lobes should be washed (Sechana) with 
a decoction of the leaves of the As'mantaka, Jambu and 
Amra (in such cases). 13. 

In a case of Parilehi, the afifected lobe (Pdli) should 
be dusted with powdered Prapaundarika, Yashti- 
madhu ^ Manjishthd and the two kinds of Haridrd after 
lubricating it with the oil cooked with the Kalkas of 
Ldkshd and Vidanga. It should be as well fomented 
with heated cow-dung and plastered with the lukewarm 
pastes of Vidanga alone, or in combination with Trivrit, 

etc, should be resorted to in cases of the affection being due to the 
concerted action of the vitiated blood and the Pitta. 

* Sarala here means Dhupa-kashtha, according to Dallana. 

64 



5o6 THE SUSHRUTA SAMHITA. [Chap. XXV. 

S'ydmd and Arka pasted together (with cow's urine\ 
or with the pastes of Karanja-SQQd, Ingudi seed, Kutaja 
and Aragvadha (pasted with cow's urine). Mustard oil 
cooked* with the admixture of all the foregoing drugs 
and with Markka, NimbaAQdiWQs and wax, proves effi- 
cacious as unguents (in such cases). 14-15. 

In cases where the ear-lobes are affected and have 
become either thin, or hard, an ointment should be 
applied to them in order respectively to increase their 
growth, or to soften them. 16. 

The marrow of a jackal and of an animal frequenting 
and living in swampy grounds (Anupa, such as a buffalo, 
etc.), together with lard; oil and fresh clarified butter, 
should be cooked with a quantity of milk weighing ten 
times their combined weight and with the drugs of the 
Madhura (Kakolyadi) group, Asva-gandhd and Apd- 
mdrga and Ldkshd-Rasa (decoction or infusion of 
Lakshi). The oil thus prepared should be filtered 
and preserved carefully in an earthen pitcher. The 
affected ear-lobes should be constantly fomented and 
well-lubricated with it. The use of this medicated oil 
helps the growth of the ear-lobes and makes them 
healthy, soft, smooth, painless, evenly developed and 
capable of bearing the weight of ear-pendants. 17, 

Treatment of Palita :— The expressed 

juice of the Bhringa-rdja and (the decoction of) Triphald, 
powders of indigo leaves, ArjunahdLvk^ Bhringa-rdja, 
Pinditaka^ black-iron, flowers of the Vija and of Saha- 
chara, Haritaki, Vibhitaka and Amalaka mh^^di together 
and pasted with a quantity of mud found adherent 
to lotus-bulbs weighing as much as the combined 

* Dallana says that this oil should be cooked with cow's urine 
weighing four times as much as the oil. 



Chap. XXV.] CHIKITSA STHANAM. 507 

weight of the aforesaid drugs should be kept in an iron- 
pitcher well covered and preserved inside a room for a 
fortnight. After this period it should be cooked with 
(an adequate quantity of) oil and with the expressed 
juice* of the Bhringardja and (a decoction of) Triphald. 
For the purpose of ascertaining the proper cooking 
of the oil, a (white) feather of a Valaka icrane) should 
be dipped into it, and satisfactory preparation should 
be judged from the deep blue colour imparted to the 
feather. The oil should be then preserved in a black- 
iron pitcher for a month, Used as anointments, this 
oil arrests a premature greyness of the hair. 18. 

The flowers of the S'airiya, Jambu, Arjuna and of 
the Kds'mari, sesamum, Bhringa-rdja-SQQds, mango- 
stones, Punarnavd, \ mud, Kantakdri^ Kdsisa, marrow of 
the seeds of Madana, Triphald, powdered iron, Rasdnjana, 
Yashti-madhu^ Nilotpala, Sdrivd, and Madayanti\ should 
be pasted together with the decoction of the Sara (pith) 
of the Vijaka. It should then be mixed with seven 
Prastha measures of the decoction of the Sara of Vijaka 
and preserved for ten days in a covered iron vessel. 
This compound should then be carefully cooked with 
an A'dhaka measure of Vibhitaka-oil and again pre- 
served in a new iron-pitcher for a month. Then after 
cleansing the system of the patient, the oil thus prepared 

* In the cases of cooking an oil, the liquid substance to be used, 
should be, as a general rule, four times as much as the oil ; but in this 
case, the expressed juice of Bhringa-rdja and (the decoction of) Triphald 
should be continued to be added, so long as the feather does not become 
deep blue. 

t According to Dallana, the reading would have b^en "T|7f^^," i.e., 
the two kinds of Punarnavd. 

X One Karsha measure of each of the aforesaid drugs should be 
taken. 



508 THE SUSHRUTA SAMHITA. [Chap. XXV 

should be used as errhines (Nasya) and in anointing the 
head, and the patient should be advised to live on diet 
consisting of Mdsha-pulse, or of Kris' ard. In the course 
of a month, it imparts a (deep black) gloss like that of 
a black bee, or that of Rasdnjana to the hair and makes 
it grow thick and curly. It cures baldness, arrests 
the susceptibility of the system to an attack of pre- 
mature decay, removes the wrinkles of the face, and 
invigorates the sense-organs in the performance oj 
their proper and respective functions. This oil should 
not be given to a man who does not wish to use it, nor 
to an indigent person, to an ungrateful wretch, nor to 
an enemy. 19. 

Treatment of Vyanga, etc. i-^Ldkshd, 

Rodhra, the two kinds of Haridrd, Manahs'ildy 
Haritdla^ Kushtha, Ndga (lead), Gairika, Varnaka^ 
Manjishthd, Vacha, Saurdshtra-mrittikd^ Pattanga, 
Gorochand, Rasdnjafia, bark of Hemdnga (Champaka), 
the tender leaves of Vata, Kdliya-Kdshtha, Padma- 
kdshtha, the filaments of a lotus, both red and white 
chandana, Mercury'^ and the drugs of the Kdkolyddi 
group should be pasted together with milk. The paste, 
thus prepared, as well as lard, marrow, wax, clarified 
butter, milk, and a decoction of the drugs of the Kshira 
trees should be cooked together. This medicated clarifie d 
butter, is the best of all the unguents that may be applied 
to the face. It cures the most difficult cases of Vyanga 
and Nilika, and removes all tans, specks, marks, moles, 
eruptions, etc., from the face. It imparts smoothness to 
the wrinkled skin, gives a healthy plumpness and bloom 
to the cheeks, and makes the face as beautiful as a lotus. 

* This is the first time that we come across the mention and use 
of "Pdrada" (Mercury) in the Sus'ruta Samhita.— Ed. 



Chap. XXV.] CHIKITSA STHANAM. 509 

It should be recommended to kings and to the ladies 
of the royal court, as well as to persons of the same 
rank. It acts as a good remedy for cutaneous affec- 
tions (Kushtha), and may be as well applied in cases of 
Vipadika. The use of a cosmetic compound consisting 
of powdered Haritaki, leaves of Nimba, the bark of 
man^Oy stems of the pomegranate, and the flowers and 
leaves of Madyantikd pasted together, imparts a god-like 
effulgence to the complexion of a man. 20-21. 

Thus ends the Twenty-fifth Chapter of the Chikitsita Sthanam in the 
Sus'ruta Samhita which deals with the treatment of a variety of diseases. 



CHAPTER XXVI. 

Now we shall discourse on the medical treatment 
for increasing the strength and virile power of weak 

persons (Kshina-Valiyam Vaji-Karana). i. 

A youth in sound health taking regularly some 
sort of Vadji'Karana (aphrodisiac) remedy may enjoy 
the pleasures of youth every night during all the 
seasons of the year. Old men^ those wishing to enjoy 
sexual pleasures or to secure the affections of women, 
as well as those suffering from senile decay or sexual 
incapacity, and persons weakened with sexual excesses, 
should do well to submit themselves to a course of 
Vdji-karana remedies. They are highly beneficial to 
gay, handsome and opulent youths and to persons 
who have got many wives. 2 -A. 

Definition of Vaji-Karana :— if duly 

taken, the Vaji-karana* remedies make a man sexually 
as strong as a horse (Vaji), and enable him to cheerfully 
satisfy the heat and amorous ardours of young maidens, 
a fact which has determined the nomenclature of this 
class of (^medicinal) remedies. 2-B. 

Means of Vaji-Karana :--Various kinds 

of (nutritious and palatable) food and (sweet, luscious 
and refreshing) liquid cordials, speech that gladdens 
the ears, and touch which seems delicious to the skin, 
clear nights mellowed by the beams of the full moon and 
damsels young, beautiful and gay, dulcet songs that 
charm the soul and captivate the mind, use of betel- 
leaves, wine and wreaths of (sweet-scented) flowers, 

* The Vsiji-Karana remedies are of three kinds, viz., (i) those pro- 
ducing the semen, (2) those secreting the semen, and {3) those producing 
as well as secreting the semen. 



Chap. XXVI.] CHIKITSA STHANAM. 51I 

and a meny careless heart, these are the best aphro- 
disiacs in life. 2. 

Causes of Sexual Incapacity :— A cessa- 
tion of the sexual desire owing to the rising of bitter 
thoughts of recollection in the mind of a man, or a 
forced intercourse with a disagreeable woman (who fails 
to sufficiently rouse up the sexual desire in the heart 
of her mate) illustrates an instance of mental impotency. 
Excessive use of articles of pungent, acid, or saline 
taste, or of heat-making articles of fare leads to the 
loss of the Saumya Dhatu (watery principle) of the 
organism. This is another kind of impotency. Virile 
impotency resulting from the loss of semen in persons 
addicted to excessive sexual pleasure without using any 
aphrodisiac remedy is the merit form of virile impotency. 
A long-standing disease of the male generative organ 
(syphilis, etc.), or the destruction of a local Marma such 
as the spermatic cord) destroys the powers of coition 
altogether. This is the fourth form of impotency. 
Sexual incapacity from the very birth is called the 
congenital (Sahaja,) impotency. Voluntary suppression 
of the sexual desire by a strong man observing perfect 
continence, or through utter apathy produces a hardness 
of the spermatic fluid, and is the cause of the sixth 
form of virile impotency. Of the six foregoing types 
of impotency, the congenital form as well as the 
one due to the destruction of any local Marma 
(spermatic cord) should be regarded as incurable, the 
rest being curable and amenable to the measures and 
remedies antidotal to their respective originating 
causes. 3. 

Their Remedies:— Now we shall describe the 
different Vayi-Karana (aphrodisiac) remedies. Powders 
of sesamum, Mdska-ipulsQ, Viddri, or S'dli-ricQ should 



512 THE SUSHRUTA SAMHITA. [Chap. XXVI. 

be mixed with Saindhava salt and pasted with a 
copious quantity of the expressed juice of the sugarcane 
of the Paundarika species. It should then be mixed 
with hog's lard, and Utkarik^ should be prepared by- 
cooking it with clarified butter. By using this 
(medicinal) Utka'rika^, a man would be able to visit a 
hundred women. 4. 

The testes of a he-goat should be boiled in milk. 
Sesamum seeds should then be successively treated 
with this milk in the manner of a Bhavand saturation. 
Cakes should be made of these sesamum seeds with the 
lard of a porpoise. This medicine exerts the same 
action as the preceding one without producing any 
exertion whatever. By eating the testes of a he-goat 
with (an adequate quantity of) salt and powdered 
long- pepper (Pippali), fried in clarified butter prepared 
from churning milk (and not from curd), a man is 
enabled to visit a hundred women. 5. 

Powders of Pippali, Mdsha-'^yA's>^, S'dli'v'icQ wheat 
and barley, should be taken in equal parts. Cakes 
(Pupatlikai) should be prepared with this compound and 
fried in clarified butter. By taking these cakes and 
a potion of milk sweetened with (a copious quantity of) 
sugar, a man becomes potent enough, to enjoy the 
pleasures of love like a sparrow (Chataka). 6. 

Powdered Viddri successively soaked in the expressed 
juice of the same and dried, should be licked with 
honey and clarified butter, whereby a man would be 
able to visit ten women successively (at a time). Simi- 
larly powders of (dried) Amalaka successively soaked 
in its own expressed juice should be licked with honey, 
sugar* and clarified butter, after which a quantity of 

* According to S'ivadasa it may also be taken with honey and clarified 
butter only. 



Chap. XXVL] CHIKITSA STHANAM. 513 

milk should be taken. This compound would make even 
an old man of eighty sexually as vigorous as ayouth. 7-8 
The testes of a he-goat or of a porpoise mixed with 
salt and powdered long-pepper, and fried in clarified 
butter should be taken for speedy and effective 
aphrodisiac purposes. The eggs of a tortoise, of an 
alligator, or of a crab,* or the semenf of a male 
buffalo, of a he-ass, or of a he-goat should be similarly 
taken for the same purpose. 9. 

Milk boiled and cooked with the sprouts, bark, 
roots and fruit of an As'vattha tree, should be sweeten- 
ed with sugar and honey, and taken ; this enables a 
man to enjoy sexual pleasures like a sparrow. The 
powdered bulbs of Viddri, weighing an Udumbara (one 
Tola) in measure, and taken with milk and clarified 
butter,! would make an old man young again. A 
Pala measure of the pulverised Mdsha pulse, mixed 
with honey and clarified butter should be licked and 
a potion of milk should then be taken ; this would 
make a man sexually as strong as a horse. Wheat and 
Atmaguptd seeds should be boiled in milk, and taken, 
when cold, with clarified butter, and a potion of milk 
should then be taken for the same purpose. 10-13. 

Clarified butter should be boiled with eggs or 
the testes (as the case might be) of alligators, mice, frogs 
and sparrows. By lubricating the soles of the feet 
with this Ghrita, a man would be able to visit a woman 
with undiminished vigour so long as he would not touch 
the ground with his feet. 14. 

* Some explain "q|f^T" as Louse-sparrows. 

t Here semen would mean the testes, the receptacle of the semen. 

X Some read "3?^^" (boiled) in place of •''§^»r". In that case the 
boiled milk only should be taken and no clarified butter should be 
added thereto. 

65 



$14 THE ^USHRUTA SAMHITA. [Chap. XXVI, 

The use of pulverised Atmaguptd and Ikshuraka 
(Kokilaksha) seeds mixed with sugar and taken with 
milk just milched enables a man to indulge in the 
pleasures of youth for the whole night without any 
sense of fatigue. The powders of the Uchchatd should 
also be taken similarly (with milk and sugar). S'atdvari 
and Uchchatd roots should also be similarly taken by a 
man wishing to have (sexual) vigour. A soup of Atma- 
guptd seeds and i^<^V/^-pulse (boiled together) should be 
taken. Atmaguptd'Secds,Gokshura seeds a.nd Uchchatd 
should be boiled wiih milk and constantly stirred with 
a ladle. The use of this preparation (with an adequate 
quantity of sugar) enables a man to enjoy the pleasures 
of love all the night long. Likewise the milk boiled 
with Mdsha-puhe, Viddri, or Uchchatd should be taken 
with honey, clarified butter and sugar. By using this a 
man may indulge in the pleasures of the bed for the 
whole night like a sparrow. 1519. 

The use of the milk of a Grishti (a cow delivered 
only once) with a grown up calf (one year old) and 
exclusively fed on the (fresh) leaves of the Mdsha- 
parnay is recommended as a sexual tonic. All kinds of 
meat and milk, as well as the drugs of the Kdkolyddi 
group should be regarded as being highly possessed of 
the virtue of imparting tone and vigour (to the male 
productive organs). They should, therefore, be used (for 
that purpose). The medicinal remedies and compounds 
described in the present chapter should be taken in 
sound health and proper seasons, as they are exhilarat- 
ing and invigorating, and help the procreation of 
children. 20-21. 

Thus ends the Twenty-sixlh Chapter of the Chikitsita Sihanam in the 
Sub'ruta Samhita which deals with the treatment of the virile impotency. 



CHAPTER XXVII. 

Now we shall discourse on the recipes and niodes 
of using elixirs and rejuvinators of the human organ- 
ism which will make it invulnerable to the inroads 
of any disease or of decay (Sarvopaghstta — 

^amaniya-Rasayanam). i. 

Metrical Texts :— A wise physician should 
(invariably) prescribe some sort of tonic (Rasdyana) for 
his patients in their youth and middle age after having 
their systems (properly) cleansed by the applications 
of a Sneha and purifying remedies (emetics and 
purgatives). A person whose system has not been 
(previously) cleansed (Sodhana) with the proper puri- 
fying remedies (emetics and purgatives) should not, 
in any case, have recourse to such tonics inasmuch as 
they would fail to produce the wished-for result, just 
as the application of a dye to a piece of dirty cloth 
will prove non-effective. 2. 

Now we shall describe the remedial measures and 
agents for the maladies due to the aggravated 
Doshas* both mental and physical, which have 
already been described (in several places). Old age 
and senile decay would be arrested (lit. perpetual or 
life-long youth would be secured) by drinking milk, 
cold water, honey and clarified butter, either severally 
or jointly (?>., in any combinationt taken one, two, 
three or four at a time\ in early life (just on or 

* The mental Doshas are Rajas and Tamas, whereas the physical 
Doshas are Vayu, Pitta and Kapha. 

t There would be four combinations of one each, six of two 
each, four of three each and one of four jointly ; thus there would be 
fifteen combinations in all. 



5l6 THE SUSHRUTA SAMHITA. [Chap. XXVII. 

just before the completion of the process of organic 
development). 3-4. 

Vidanga-RaS^yana :— The powdered seeds 
of the Vidanga (Tandula) and pulverised Yashti-madhu 
should be mixed together and taken in cold water in 
an adequate dose (according to the strength of the 
patient), and a potion of cold water should then be 
taken. This medicine should be regularly continued 
for a month. The same pulverised Vidanga seeds 
should be similarly taken for a month through the 
vehicle of the decoction oiBhalldtaka mixed with honey ; 
or of the decoction of grapes mixed with honey ; or 
with the expressed juice of Amalaka sweetened with 
honey ; or through the vehicle of the decoction of 
Guduchi. Thus there are these five ways (of taking 
pulverised Vidanga seeds (Tandula) as an e^xir. A 
meal of boiled rice with a copious quantity of clarified 
butter should be taken with the soup of Amalaka and 
Mudga pulse unseasoned with salt and cooked with only 
a small quantity of Sneha (clarified butter) after the 
medicine has been well digested. These (Ras^yana) 
remedies prove curative in cases of haemorrhoids and 
in complaints of worms. They improve memory and 
the power of comprehension and their use for every 
month increases the life-time of the user by one 
hundred years. 5. 

Vidanga-Kalpa :— One Drona measure of 
Vidanga (seeds) should be boiled in the way of 
preparing cakes in an Indian cake-pan. When the 
watery portion (of the cakes) have been removed (eva- 
porated) and the Vidaitga-^x^va'^ well boiled, they should 
be taken down and well pasted on a stone-slab. They 
should then be kept in a strong iron pitcher after 
having been mixed with a copious quantity of the 



Chap. XXVII.] CHIKITSA STHANAM. 517 

decoction* of Yashti-madhu. The pitcher should be 
buried in a heap of ashes inside a closed room 
during the rainy season and preserved there during the 
four months of rain ; after that period the pitcher should 
be taken out (of the ashes). Its contents should then be 
consecrated with (appropriate) Mantras by uttering them 
a thousand times and should be taken every morning 
in suitable quantities after the system has been thoroughly 
cleansed (by appropriate emetics and purgatives, etc.). 
The diet should consist of cooked rice and clarified 
butter mixed with a copious quantity of the soup of 
Mudga pulse and -^w^/^/^^ cooked with a small quantity 
of Sneha and salt j and should be taken after the 
digestion of the medicine. The patient should lie on 
the ground (and not on a bedding). Worms would be 
found to have been issuing out of the body after the 
regular and continuous use of the medicine for a month, 
which should be extracted with the aid of a pair of 
bamboo tongs or forceps after the body had been anoint- 
ed with the Anu-taila (described before) Ants would 
be coming out of the body during the second, and ver- 
mins (Yuka) in the third month of the use of the medi- 
cine which should also be removed as in the preceding 
manner. The hair, nails and teeth begin to fall off and 
become dilapidated in the fourth month of its use. In 
the fifth month the body beams with a divine glow, 
becomes resplendent as the midday sun, and exhibits 
features which specifically belong to the etherial being. 
The ears become capable of hearing the faintest and 
remotest sound (under its use), and the vision extends 
far into space and beholds objects at a great range 

* Dallana explains the term Madhukodakottara to mean a large 
quantity of Madhuka and water, (and by water he means the decoction of 
Vidanga). 



5l8 THE SUSHRUTA SAMHITA. [Chap. XXVII. 

(which is not usually given to mortal eyes to descry). 
The mind, shorn of the qualities of Rajas (action) and 
Tamas (nescience), becomes possessed of Sattva (illumi- 
nating principles or true knowledge). Things are per- 
manently and indelibly impressed upon his (user's) 
memory at a single hearing and the faculty of inven- 
tion wonderfully expands. Old age and decay perma- 
nently vanish and youth returns to stay in him for 
good, bringing with it an elephantine strength and a 
horse-like speed, and he is enabled to live for eight 
hundred springs The medicated oil known as Anu- 
taila should be used in anointing (the body at this 
stage of treatment) ; a decoction of Aja-karna for 
Utsddana .washing) purposes^ well-water saturated with 
Us'ira for bathing purposes, sandal paste in anointmg 
(Anulepana) the body, and the regimen of diet and 
conduct as described in connection with the Bhallsktaka 
treatment (Vidhdna^ should be observed. 6. 

Kasmarya Kalpa :— The use of huskless 
Kats'maryaja seeds for rejuvinating purposes, is similar 
to the preceding one, except that it requires a separate 
kind of diet and does not require the use to lie on the 
ground. Under this treatment, the diet should consist 
of (boiled) rice and well-boiled milk and the beneficial 
effects that would result from its use, are identical with 
those of the foregoing one. These remedies should 
b3 employed \\\ diseases originatiag through the 
vitiated blood and Pitta of the system. 7. 

Vala- Kalpa :— A Pala or half a Pala weight 
of the (powdered) roots of the Vala should be well-stirred 
in cow's milk and taken (every day\ and the patient or 
the user should not be allowed to stir out of his room as 
prescribed before (during the entire course of taking the 
rnedicine\ He should be advised to take a meal con- 



Chap. XXVII.] CHIKITSA STHANAM. 519 

sisting of boiled rice, milk and clarified buttor after the 
medicine had been fully digested. Premature old age 
and senile decay would be arrested for a period of twelve 
years by taking this elixir continuously for twelve 
days in the foregoing manner, whereas an extension 
of its course to a hundred days would add a hundred 
summers to the duration of his ) outhful age. Ati-valai, 
Naga-valai, Vidatri, Satatvari may be similarly taken 
for the same purposes^ with this distinction that the 
(powders of) the Ati-vald should be taken with water, 
those of the Ndga-vald, with honey, whereas Vz'ddrz a.nd 
the S'atdvari powders should be taken with milk. The 
regimen of diet and conduct as well as the beneficial 
results produced therefrom should be the same (as from 
the use of Vald). The present remedies are recom- 
mended to persons seeking strength or suffering from 
an attack of Hoematemesis or Hoematochczia * 8. 

Vsfrah! Kalpa : — A Tuld measure of the 
powders of Vs^rakhi-bulbs should be taken in an adequate 
dose (everyday) by mixing it with honey and stirring 
it with milk A meal of boiled rice with clarified 
butter and milk should be taken after it had been 
digested and the patient should be advised to observe 
a regimen of diet and conduct (Pratishedha) as laid 
down before (in connection with the foregoing elixirs). 
By using it a man is enabled to witness a hundred 
summers and does not feel any fatigue after sexual 
excesses. A quantity of this powder should be mixed 
with milk and boiled (according to the rules of Kshira- 
pdka). When sufficiently cooled, the milk should be 
churned and the clarified butter produced therefrom 
should be taken after the medicine had been digested. A 

* Suffering from consumption and hoemoptysis. — D. R. 



520 THE SUSHRUTA SAMHITA. tCk^ XXVIL 

continuous use of the medicine for a month enables a 
man to live up to a good hundred years. 9. 

A decoction should be made by boiling together 
the pith of the Vijaka* (Pita Sila) and the roots of the 
Agni-mantha with which a Prastha measure of Mdska- 
pulse should be duly cooked. When the Masha-pulse is 
sufficiently boiled, an Aksha measure of powdered 
Chitraka roots and the expressed juice of the Ama/aMa 
weighing a fourth part of the 3fds/ia-pu\sQ should 
be added to it, and the whole compound should be 
removed (from the oven) at the close of the cooking. 
When cooled down this compound should be taken in 
adequate doses with honey and clarified butter after 
consecrating it a thousand times with appropriate 
Mantras. Persons seeking longevity and a stronger or 
improved range of vision should take this and they 
should be advised to take their meals without any salt. 
The meal, after the digestion of the medicine, should 
consist of boiled rice and a copious quantity of clarified 
butter and should be taken with unsalted Mudga, and 
Amalaka soup or with milk alone. A continuous use 
of either of these two medicines for three consecutive 
months would make a man's eye-sight as keen and 
foresighted as that of a Suparnat and enable him to 
witness a hundred summers in the full vigour of health, 
strength and manhood.^ 10. 



* Dallana recommends one Pala weight of Vijaka Sira and Agoi- 

manlha to be boiled in an Adhaka measure of water which should be 
reduced to one half for the preparation of the decoction. 

t Suparna is the king of birds and is said to be the most keen- 
sighted . 

X Dallana says that some commentators do not read this, since they 
do not consider it to be a part of the original text. Jejjata also has not 
read this. 



Chap. XXVII.] CHIKITSA STHANAM. 52I 

IVIemorable Verse :--The use of Sana (seeds) 

boiled with milk and taken also with milk guards 
against the loss of flesh and prevents the body from 
suffering any decay, i r. 

Thus ends the Twenty-seventh Chapter of the Chikiisita Sihanam in the 
Sus'ruta Samhitd which deals with elixirs and rejuvenators. 



66 



CHAPTER XXYIII. 

Now we shall discourse on the elixirs and remedial 
agents which tend to improve the memory and invigor- 
ate the mental faculties as well as to increase the 

duration of human life (IVIeclhayushkamiyam 
Rasayanam). i. 

iSvctavalguJa-RassTyana :— The fruit 

(seeds) of the white Avalguja should be dried in the 
sun and then reduced to a fine powder. This powder 
should be stirred with (an adequate quantity of) treacle 
and placed in an earthen pitcher which previously 
contained clarified butter (Sneha-kumbha). The pitcher 
should then be kept buried in a heap of paddy for 
seven days after which it should be taken out and 
its contents given in convenient doses every morning 
before sunrise to a person, seeking improvement of 
memory and longevity, after his system has been 
thoroughly cleansed ^with proper emetics and purgatives, 
etc.). Hot water should then be drunk. After taking 
the medicine, th? patient should enter his room in 
accordance with the rules laid down in connection with 
the Bhallataka-Vidhdna. After the digestion of the 
medicine, the patient should be advised to take a cold 
bith and to partake in the evening of a meal of 
well-cooked S'dli or Shashtika rice with (^boiled) milk 
sweetened with sugar. This medicine continuously 
taken in this manner for six months would make the 
life of its user sinless, and extend it in the full glow 
of health and vigour and in the sound enjoyment of 
a vigorous memory and of all his intellectual faculties 
to a hundred green summers. 2. 



Chap. XXVIIL] CHIKITSA STHANAM. 523 

In cases of Kushtha, jaundice and abdominal 
dropsy (Udara), the medicine should be prepared by 
stirring (the powdered seeds of) the Krishn^i* (^black 
Avalguja) with the urine of a cow (instead of with 
treacle) and given to the patient in doses of half a Pala 
weight every morning after the sun has ceased to look 
red.f In the afternoon the patient should be made to 
partake of a meal of boiled rice with clarified butter 
and unsalted A'malaka soup. A continuous use of this 
medicine in the aforesaid manner for a month would 
improve the memory and intellectual faculties of the user, 
and enable him to witness a hundred summers on earth 
in the full enjoyment of sound health. Chitraka rootsj: 
and Rajani (turmeric) may be used in the same 
manner and for similar purposes with this distinction that 
the dose of the Chitraka-xoo\. preparation should be two 
Pala measures (instead of half a Pala as laid down in 
regard to the foregoing compounds). The rest are 
identical with the above. 3. 

lYIanduka-parni Rasayana: The Doshas 

of the system of a person should be first thoroughly 
cleansed (with the help of proper emetics and purgatives, 
etc.), and he should be advised to undergo the prescribed 
diet of vPeyd, Yavdgu, etc . in their proper order) He 
should be further advised to enter his chamber in the 
prescribed manner (and to remain there during the entire 



•Jejjata explains "Krishna" to mean Pippali. But both Gayi and 
Dallana explain it to mean the black Avalguja. It should be mentioned, 
here, that Dallana recommends the roots of black Avalguja, but we think 
th.^t its seeds should be taken. — Ed. 

t Before sunrise. — D. R. 

X The roots of the Chitraka with black flowers should be taken. — 
Dallana. 



524 THE SUSHRUTA SAMHITA. LChap. XXVIII. 

course of the treatment). An adequate dose of the 
expressed juice of the Manduka-parni should then be 
stirred with milk, and should be taken after consecrating 
it by reciting the proper Mantras a thousand times. 
A potion of milk may then be taken immediately after. 
After it had been fully digested a meal of cooked 
barley grains with milk should then be partaken of; 
or (the expressed juice of Manduka-parni) with an 
admixture of sesamum seeds followed by a potion 
of milk. A meal of boiled rice with milk and clarified 
butter should then be taken after the digestion of 
the medicine and should be continued for three 
months in succession. This would ensure a long life 
of a hundred years in the full vigour of retentive 
memory and intellectual faculties, and would impart a 
god-like effulgence to the complexion. As an alter- 
native, the patient should fast three days and take 
only the expressed juice of Manduka-parni for these 
three days. After this period he should live on milk 
and clarified butter only, or he should be made to take 
a Vilva measure (of the paste of Manduka-parni) stirred 
with milk for ten consecutive days which would ensure 
a life of a hundred years in the full enjoyment of his 
intellectual faculties. 4, 

Br^hmi Rasayana : -Having had the Doshas 
of the system duly cleansed (with proper emetics 
and purgatives, etc.), a person (wishing to undergo a 
treatment of RasayanaJ should be advised to take the 
prescribed diet of (Pey^. Yavdgu, etc., in their proper 
order), and should be made to enter his room (Ag.4ra). 
He should then take the expressed juice of the Brathmi 
in an adequate dose after consecrating the juice a 
thousand times with the proper Mantras, After the 
medicine had been fully digested he should be advised 



Chap. XXVIII.] CHIKITSA STHANAM. 525 

to take in the evening Yavdgu (gruel) without any salt ; 
or with boiled milk in the event of his being habituated 
to its use. A continuous use of the medicine for a 
week improves the memory, leads to the expansion of 
the intellectual faculties and imparts a celestical glow 
to the complexion. In the second week of its course it 
revives old and forgotten memories in the user and adds 
to his proficiency in the writing out of any book to 
be written. In the third week it enables a man to repro- 
duce from memory as many as one hundred words if 
twice heard or read (at a single sitting'. In the same 
manner a (further) use of the drug for twenty-one days 
removes all inauspicious features whether of the body 
i r of the mind, the goddess of learning appears in an 
embodied form to the (mind of the) user, and all kinds 
of knowledge come rushing into his memory. A single 
hearing is enough to make him reproduce {verbatim 
from memory a discourse however lengthy "), and he is 
enabled to live for five hundred years. 5. 

Brahmi Ghrita :— Two Prastha measures of 
the expressed juice of th>; Braihmi and one Prastha 
measure of clarified butter should be cooked with one 
Kudava measure of Vidanga seeds, two Pala weight of 
each of Vacha and Trivrit, and twelve (in number) 
of each of Haritaki, Amalaka and Vibhitaka well 
pounded and mixed together. When properly cooked, 
the (prepared) Ghrita should be carefully preserved in a 
covered pitcher. It should then be taken in adequate 
doses as in the preceding manner. The patient should be 
advised to take meals of boiled rice, clarified butter and 
milk^ after the medicine had been fully digested. 
Under its use worms and vermin would be expelled 
(^from their unsuspected seats in the organism) and creep 
out of the upper, lower and lateral parts of the body. 



$26 THE SUSHRUTA SAMHITA. [Chap. XXVIII. 

This preparation would give a favourable turn to one's 
fortune, impart a lotus-like bloom (to the cheeks) with 
perpetual youth, unparalleled intellectual faculties and a 
life that would cover a period of three centuries of song 
and sunshine. This elixir orRasa^yana covers within its 
therapeutic range such affections of the body as cutane- 
ous diseases (Kushtha\ chronic fever, epilepsy, insanity, 
and the diseases due to the effect of poisons and to the 
evil influences of ghosts and malignant spirits, as well 
as of all other dangerous diseases. 6. 

Vacha Rasayana:— A paste of white Vachai 

to the size of an Amalaka should be taken with (an ade- 
quate quantity of) milk, after consecrating it (in the 
proper manner). The medicine should be taken after 
cleansing the system (with emetics and purgatives, 
etc.) and after entering the Agara (room). After the 
medicine had been digested, a meal of boiled rice with 
milk and clarified butter should be partaken of. A 
continuous use of this elixir for twelve days improves 
the power of hearing. It increases the power of 
memory if taken for the next twelve days. It enables 
the user to remember a hundred words at a time by 
a thrice repetition of the same (z>., by taking it for a 
period of thirty-six days). A repetition of a twelve days' 
(2>, forty-eight days) use of the medicine leads to 
the expiation of all sins ; it imparts a keenness of sight 
like that of Garuda and enables the user to witness a 
hundred summers on earth. A decoction prepared with 
two Pala weight of any other species of Vach£^ should 
be taken with milk.* The benefits which would result 
from its use and the rules of diet and conduct to be 



* According to Dallana, this preparation of Vacha should be ptc 
pared by boiling it in the manner of Kshira-pdka Vidhi, 



Chap. XXVIII.-, CHIKITSA STHANAM. 52/ 

observed (during its course} are identical with those of 
the preceding one. 7. 

^ata-psLka Vacha-Ghrita ".—Clarified 

butter should be cooked a hundred times in succession 
with an adequate quantity of Vachai. The use of a 
Drona measure of this medicated Ghrita (taken every 
day in an adequate dose) extends the earthly career of 
its user to five centuries, and proves beneficial in cases 
of scrofula, goitre, elephantiasis and hoarseness. 8. 

Measures for prolong^ing life— IVI. T. : 

— Now we shall discourse on life-prolonging measures 
and remedies. The powders of Vilva (roots) should 
be consecrated a thousand times with Vilva flowers by 
reciting the SreeSukta (as mentioned in the Rig- 
Veda), They should then be mixed with (powdered) gold, 
honey and clarified butter (in the form of an electuary), 
and licked every morning. It is thus a combination of 
medicine and Mantra, and, if used continuously for a 
year, would remove all inauspicious features (both of 
the body and of the mind). 9-10. 

Every morning after a bath^ a man should offer ten 
thousand oblations in fire and take the powders and decoc- 
tion of the roots and bark of the Vilva with milk in a 
spirit of self-control, whereby he would be able to 
acquire longevity. This remedy should be considered as 
a good Rasiyana. Similarly a decoction of Mrina^la 
mixed with honey and fried paddy and duly consecrated 
a hundred thousand times with oblations in fire would 
be considered an infallible Rasdyana. 11-12. 

The use (of a compound consisting of gold, Padma- 
reed, PriyangU and fried paddy mixed with honey 
and taken in (an adequate quantity of) cow's milk 
gives a favourable turn to one's fortune. A potion 
of milk cooked with the decoction of the petals (Dala) 



528 THE SUSHRUTA SAMHITA. C^hap. XXVIII. 

of Nilotpala (in the manner of Kshira-p^ka Vidhi) and 
mixed with gold and sesamum seeds^ is attended with 
similar results. 13-14. 

Cow's milk with gold, wax and Mdkshika (honey), 
if (regularly) taken after having performed a Homa 
ceremony a hundred thousand times, should be consider- 
ed the best Rasayana. The use of the pulverised com- 
pound of the three things viz., Vachd, gold and Vilva, if 
taken with clarified butter, tends to improve the health, 
memory, intellectual powers and physical growth. It 
increases the duration of one's life and brings good luck 
in its train. 15-16. 

A (medicated) oil prepared by duly cooking it with 
the decoction of a Tuld weight of Vdsd-roots should be 
taken by a man after having performed a Homa cere- 
mony with a thousand libations for the expansion of 
his intellectual faculty and the increase of the duration 
of his life on earth A Tul^ weight of barley grains 
should be powdered. The preparations of this barley 
powder (gradually) taken with honey and powdered 
Pippa/i incresises one's capacity for study. 17-18. 

The use of pulverised Amalaka and gold with 
honey imparts vitality to a dying man. A regular use 
of the Sataivari-ghrita mixed with honey and pulveris- 
ed gold enables a man to subjugate even his king. 
A compound consisting of Go-chandand, Mohanikd, 
honey and gold should be taken by a man wishing a 
good turn to his destiny 19-21, 

Clarified butter cooked with an admixture of the 
pasted Yashti-madhu and with the decoction of Padma 
and Nilotpala should be regularly taken with gold, and 
then a potion of milk cooked with the foregoing drugs 
should be taken. It invariably removes the evil features 
(of both mind and body), and gives a good turn to 



Chap. XXVIII.] CHIKITSA STHANAM. 529 

fortune. It increases longevity and makes the user 
(fortunate like) a king. 22-A. 

The Tri-padi (lit. three-footed) GAyatri should be 
recited in connection with the use of any of these elixirs 
where no Mantra would be found to be specifically 
mentioned. The use of the foregoing medicinal com- 
pounds improves one's beauty, surrounds a man with the 
majesty and effulgence of the gods and makes him as 
strong as an elephant. Constant study, disquisitions 
(on philosophical and scientific topics), discussions in 
other subjects, and residence with professors or men 
learned in the respective branches of knowledge, are the 
best means for improving memory and expanding one's 
intellect. Eating after the digestion of a previous meal, 
non-repression of any natural urgings of the body, 
annihilation of all killing propensities, perfect contin- 
ence, self-co ntrol and refraining from rash and hazard- 
ous undertakings, should bs deemed the keys to a 
long life. 22. 

Thus ends the Twenly-eighlh Chapter of the Chikitsila-Slhanam in 
the Sus'ruta Samhita which deals with elixirs and remedial agents for 
improving the memory and intellect and increasing longevity. 



6; 



CHAPTER XXIX. 

Now we shall discourse on the restorative and on 
the constructive agents (Rasdyana) which arrest innate 
morbific tendencies and decay* (Svabh^Vlka- 

Vyadhi Pratishcdhaniya Rasayana) i- 

IVIetrical Text : —in the days of yore the gods 
such as Brahma, etc created a kind of Amrita ambrosia) 
which is known by the epithet of Soma, for the preven- 
tion of deathf and decay of the body. We shall now 
deal with the mode of using this (ambrosia). 2. 

The one and the same divine Soma plant nr,ay be 
classified into twenty- four species according to the differ- 
ence of their habitats, structures, epithets and potencies. 
They are as follows: — Ams'umdn, Munjavdn, Chandra- 
mdh, Rajataprabha^ DuiudSoma, Kaniydn, S'vetdksha^ 
Kanaka prahha.Pratdnavdn^ Tdla vrinta^ Karavira, Ant- 
s' avdn, Svayam-prahha^ Mahd-soma, Garuddhrita, Gdya 
trya^ Traishtuhha, Pdmkta^ fdgata, S'dmkara, Agni- 
shtonia, Raivata, Yathokta and Udupati, All these 
kinds of Soma secure for the user a mastery of the 
G^yatri (and hence in the Vedas), and are known by the 
above auspicious names mentioned in the Vedas \ 

* These are decrepitude, death, hunger, thirst, sleep, etc. 
t Here death may mean, according to some authorities, the death 
of tissues as well. 

X The whole of the hymns in the gth Book of the Rig-veda, besides a 
few in other places, are dedicated to the honour of Somaj but these tweniy- 
four names do not occur there. The plant is there represented as a god, 
and his worship must at one time have altaired a remarkable popularity. 
The extraordinary properties of the exhilarating juice of the Soma are 
frequently mentioned in the Rig-veda and the language throughout in 
which it is behymned could not be more eulogistic. As an instance of 



Chap. XXIX.] CHIKITSA STHANAM. 53 1 

Their virtues and methods of using them are identical 
with each other and are described below. 3 4. 

Mode of using the Soma :— A room or an 

inner chamber (AgSLra) in a commendable site protected 
with three walls on each side and provided with all kinds 
of accessories and attendants, should be first secured 
before taking (the expressed juice of) any of the aforesaid 
Soma plants. Then at an auspicious hour on an auspi- 
cious day marked by favourable astral combinations 
and lunar phase, the person desirous of using the Soma 
should enter the inner or central Chamber after having 
had his system cleansed (with the proper emetics, purga- 
tives, etc ) and having had his diet in the proper order (pf 
Peyd, etc.). A (whole) plant of the Ams'mndn (or of any 
other kind of) Soma should be procured in the manner 
to be observed at the time of collecting the Soma for an 
(Agni-shtoma) sacrifice and (all) the (preliminary) rites 
of Homa should be performed (in the usual orthodox 
way). After that the bulb (of the Soma plant) should be 
pricked with a golden needle and a quantity of the 
secreted milky exudation should be collected in a golden 
vessel. The patient (with the auspicious rites of protection, 



this we might refer to Rigveda VIII. 48.3 which has been metrically 
translated by Muir as follows : — 

We've quaffed the Soma bright, 

And are immortal grown ; 

We've entered into light, 

And all the gods have known. 

What mortal now can harm. 

Or foeman vex us more ? 

Through thee, beyond alarm, 

Immortal god, we soar. 
It should be mentioned, however, that as far as our knowledge goes, 
this Soma is now-a-days not within our reach.— E(}, 



532 



THE SUSHRUTA SAMHITA. [Chap. XXIX. 



etc., done unto him) should drink off an Anjali (Kudava) 
measure of the secreted juice at a draught without tast- 
ing it, and the remainder, if any, should be cast into 
water. He should then wash and rinse his mouth with 
water in the manner of Achamana. Then having 
controlled his mind and speech with the vows cf Yama 
(paramount duties/ and Niyama (minor duties)+ 
should stay in the protected inner chamber surrounded 
by his friends. 5. 

Metrical Text :— After having drunk the 
Rasdyana (Elixir) one should reside in a windless (pres- 
cribed) chamber; spend his time in perfect control over 
his senses, sitting, standing or walking about in his 
chamber in a holy spirit and by no means indulging in 
sleep (which is injurious under the circumstances). 6. 

Or the patient may, after taking his meal in the 
evening and hearing the benedictory words, lie down 
on a mattress of Kus'a-grass covered with black-deer 
skin and thus pass the night among his friends and may 
take cold water when thirsty. Then having got out of 
his bed in the morning he should hear the benedictory 
words recited and have the benedictory rites performed 
unto him. He should then touch the body of a cow 
and sit down in the same manner (in his chamber). 
Vomitings mark the digestion of the Soma-juice and 
after vomiting the blood -streaked worm-infested matter, 

*Patanjali, the propounder of ihe Yoga system of Philosophy, 
enumerates the Yamis as follows: — "=?jf%:^" (harmlessness), "^(?j" 
(truthfuln.'ss), '■•'?[^?j" (abstinence from stealing), "jfij'^" (continence) 
and "'^nrf^f" (non-acceptance of offerings except in prescribed cases). 

tThe Niyamis, according to the same authority, are: — "?^^" 
(purity — external or internal), ''^5^" (contentment) "cPT;^^ (penance), 
"^To5(T^" (religious study) and "|;'??:-^<!r^»T ' (meditation of the Divine 
gPeing). 



Chap. XXIX ] CHIKITSA STHANAM. 533 

milk boiled and cooled should be given him in the 
evening. Worm-infested stools follow on the third day 
(of its use) which help the system in purging ofif all filth 
and obnoxious matter (accumulated in the organism) 
through errors in diet and conduct, etc. The patient 
should in that case bathe in the evening and take cold 
boiled milk as before and lie down on a piece of 
Kshauma cloth stretched over (the aforesaid mattress). 
Swellings appear on the body on the fourth day (of its 
use) and worms are found to creep out from all parts 
of the body. The patient should He down that day on 
a bed strewn over with dust and in the evening, he 
should be made to drink a potion of milk as before. 
He should pass the fifth and sixth clay in the same 
manner, but milk should be given him in the morning 
and in the evening (instead of only in the evening). 
The muscles become withered by this time and on the 
seventh day the patient is found to be a mere skeleton 
covered with a skin only and left with bare animation, 
the vital spark being retained by the potency of Soma. 
The body should be washed with tepid milk on that 
day and plastered with a paste of sesamum, Yashti- 
madhu and sandal wood, and milk (only) should be 
given him to drink. 7-A. 

On the morning of the eighth day, the body should 
be washed with milk, and plastered with sandal paste, 
and potions of milk should be prescribed for him after 
which the patient should be advised to leave his bed 
of dust and lie down on one covered with a piece of 
Kshauma cloth. From now the muscles of the body 
begin to show signs of fresh and vigorous growth, 
the skin becomes cracked, and the teeth, nails and 
hair begin to fall off. On and from the ninth day the 
rnedlcinal oil known as A.nu-Taila should be used to 



554 THE SUSHRUTA SAMHITA. [Chap. XXlX 

anoint (the body) and the decoction of Soma-valka for 
bathing (Pari sheka). The same should be prescribed 
on the tenth day, and from thence the skin becomes 
firm. The eleventh and twelfth day should be passed 
in the same way. From the thirteenth till the sixteenth 
day (both the days inclusive) the body should be washed 
with the decoction of Soma-valka. New teeth well- 
formed, symmetrical, strong, hard and as clear as a 
diamond or crystal or ruby would appear on the seven- 
teenth and eighteenth days. Gruels (Yavdgu) pre- 
pared with old S'dli-rice and milk should form his diet 
till the twenty-fifth day. After that period well boiled 
S'dli rice should be taken in the morning and evening 
with milk. Fixed, glossy and coral coloured finger- 
nails resembling the new rising sun in lusture and 
possessed of auspicious marks would be found to be 
growing after the lapse of that period and hair begin 
to grow, the skin would assume the soft hue of a blue 
lotus (Nilotpala), Atasi flower or of a ruby stone. 
After a month the hair should be shaved and a plaster 
composed of Us'ira, Chandana and black sesamum 
applied to the scalp, and the patient should take a 
milk-bath. This would lead to the growth of deep 
bee-black curls of hair in the course of a week. 7-B. 
Then the patient should be allowed to stir out from 
the inmost chamber only to re-enter it again after a stay 
of a Muhurta (forty-eight minutes) in the outer chamber. 
Thenceforth Vala^ taila (described before) should be used 
in anointing (Abhyanga) his body ; pasted barley in 
rubbing (Udvartana) ; tepid milk in washing (Parisheka) 
it ; and a decoction of Aja-karna in rubbing (Utsddan